What does a syphilitic chancre look like? Syphilis symptoms photo. What does hard chancre look like in women

Initially, it should be said that a hard or syphilitic chancre in women is not the only ulcerative formation in a sexually transmitted disease. There is also such a thing as a soft chancre. Despite the large number of differences between these two types of formations, venereologists cannot always determine with accuracy what type of venereal infection we are talking about. For accurate diagnosis and preparation of a program, it is necessary to undergo a complete examination of the body and determine the causative agent of the disease and its source at the microbiological level.

In this section of the article, it is worth talking about chancre in women as a direct sign of the onset of the primary stage of syphilis. Hard chancre is the most common type of chancre, occurs in both women and men, and has three stages of growth. The first stage is considered to be the most dangerous, since the manifestation of the disease is not always easy to identify and consult a doctor in time. The causative agent of ulcerative formations on the body of an infected person is the spirochete or syphilis carrier bacterium.

Chancre occurs due to the entry into the blood of the bacterium syphilis, which is transmitted through unprotected sexual contact through the mucous membrane. Due to the active sexual life of a modern person, cases of hard chancre on the mucous membrane of the mouth and anus have become more frequent today. Medicine also knows cases of infection with the spirochete bacterium by doctors when examining or operating on an infected person. The pathological form of a hard chancre on the hands is characterized by pain and fever, which is not observed in other forms of such formation.

The incubation period of hard chancre in women takes no more than 4 weeks. During this time, the treponema bacterium attaches to the mucous membrane and begins to produce toxins, as well as divide. In the place where the spirochete multiplies, a slight reddening occurs, which later turns into an ulcer - this is the chancre.

Many of our readers are interested in what a chancre looks like in women. There are a number of features due to which a hard chancre can be distinguished from other similar types of manifestations of a venereal infection on the body:

A hard chancre is called a hard chancre because it has a cartilaginous base that can be felt with a little pressure on the edges of the ulcer.
The edges of the hard chancre are clearly defined and slightly raised above the base of the wound.
The skin adjacent to the chancre in the normal state of infection is not inflamed or damaged.
Inside, the chancre is painted bright scarlet or brown, depending on its location.
From above, the ulcerative wound is covered with a smooth film, with pressure on which a small amount of brown liquid oozes out of it.
Hard chancre does not cause pain, does not itch or burn, does not provoke attacks of fever or dizziness.

Remember that self-diagnosis of the disease can lead to serious consequences and a significant deterioration in the course of the disease. At the slightest sign of the appearance of solid chancre on the body, you should immediately contact a specialized clinic and conduct a complete examination of the body, instead of looking for answers to queries in search engines: “chancre on the labia”, “chancre syphilitic in women”, “chancre in vagina”, “chancre in women symptoms”, “what does chancre look like on the labia”, “chancre pictures in women”, “chancre what is it in women”, “syphilis chancre in women”, “treatment of chancre in women”, “ chancre in a woman on the labia”, “what does the chancre of the initial stage look like in women”. Remember that a timely visit to the doctor is the key not only to a quick recovery, but also to the well-being of your partner.

On what parts of the body does chancre develop in women?

It is worth saying that the localization of hard chancre in women is much more complicated than in men. Often chancres in women can occur on the cervix or on the labia minora, which is why it is almost impossible to notice them in time and provide first aid in case of a disease. The painlessness of hard chancre often causes advanced forms of syphilis, which also could not be detected on time.

IT'S IMPORTANT TO KNOW!

Localization of hard chancre in women in the mouth is marked by the formation of large ulcerative cracks. On the oral mucosa, the primary signs of syphilis may appear on the tongue, inside of the cheeks, lips, or palate. The form of chancre cracks in women is also acquired on the anus.

It is important to know that a syphilitic-type hard chancre is predominantly a one-time ulcerative formation that does not spread throughout the body and does not cause concomitant skin edema. However, in special cases, such as when an ulcer ruptures or the surface of the wound is damaged, spirochete bacteria can spread to healthy areas of the skin and cause pathological ulcerative lesions of a multiple type. With untimely treatment, a hard chancre in women can develop to a gigantic size and cause swelling of the lymph nodes, fever and bouts of vomiting.

How to diagnose hard chancre in women?

Self-diagnosis in case of infection with syphilis is absolutely not applicable, since at the moment there are a large number of different types of chancre and their combinations, which are simply impossible to determine at home and make a correct diagnosis. A number of microbiological tests are used to diagnose the chancre of an infected person:

The first method is to take a swab from the ulcer wound of an infected person. This method is used in the primary stage of syphilis, when the development of a hard chancre reaches its peak and a large number of spirochetes accumulate in it. However, it is worth remembering that a few days before taking a smear, the affected area should be treated with special agents that kill the natural microflora and other bacteria, so that the results of the study are as reliable and clear as possible.

Complicated forms of chancre may be a reason for a repeated treponemal type or analysis based on antibody counts. Both methods are more likely to determine the type of sexually transmitted disease that caused the sores on the body, and prescribe the most effective treatment.

Soft chancre in women and the causes of its appearance

The similarity of the name of chancres does not indicate their similar characteristics and ways of manifestation. A chancre in women is a bleeding ulcerous formation on the body that occurs when a bacterium called Ducrey's bacillus enters the bloodstream. A large percentage of those infected with this type of chancre live in countries with a hot tropical climate.

Soft chancre is very rarely diagnosed in women. This is due to the fact that in the female body, the Ducrey bacterium is in a latent form and very rarely manifests itself pathologically. Medicine knows cases when the bacterium was in the body of a woman for many years and was not diagnosed. However, during sexual contact with an infected woman, a man runs the risk of becoming a carrier of this bacterium and further facing the occurrence of multiple soft chancres on the body.

Distinctive characteristics of soft chancre are:

Irregular edges that can enlarge over time and cause multiple inflammations in adjacent areas of the skin.
Increased soreness of ulcerative wounds, burning.
Bleeding ulcers.
Discharge by pressure of a large amount of purulent and bloody fluid.
The ability to increase in size and provoke the emergence of other foci of inflammation, which ultimately form a large ulcerative lesion of the skin.

A mild chancre can cause attacks of fever, nausea, dizziness, headaches, multiple inflammations of the lymph nodes, and digestive system disorders.

After healing, the soft chancre leaves behind a large scar that does not disappear with time.

How to identify and treat soft chancre in women

Diagnosis of soft chancre, like hard chancre, occurs most often by taking a smear from the affected area of the skin. Treatment of this type of venereal infection is carried out by taking and carefully externally treating the affected areas of the skin in order to eliminate the likelihood of developing pathological forms of the disease and protect the infected person from recurrent forms of infection. It is important to note that exposure to Ducray's bacteria with general spectrum antibiotics has no effect, since this type of microorganisms is insensitive to their composition. In the event of a soft chancre, the doctor prescribes the use of highly targeted antibiotics, which not only help to destroy the bacteria that cause the infection, but also help prevent the risk of recurrence of the disease.

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Become the scourge of modern society. Can they be detected at an early stage? Yes, if, for example, we are talking about a syphilitic chancre. What it is?

This article will examine in detail the question of how the syphilitic chancre looks and what are its features. It will also be possible to learn how to treat this infection. And, of course, photos of the syphilitic chancre and its manifestations will be given.

How does it appear

Syphilis is a serious and severe sexually transmitted disease. In the first stages (during the first weeks after infection), it manifests itself in the form of chancres.

What it is

From the above, it becomes clear that the syphilitic chancre is the initial stage of syphilis. Outwardly, it manifests itself as a purulent neoplasm, compacted inside, and covered with a crust on the outside. Most often, these ulcers do not cause inconvenience or discomfort to patients, that is, they do not hurt, itch or cause inflammation.

On the other hand, if you do not contact a specialist in time, such skin pathologies can develop into malignant formations or erosion, as a result of which not only the skin, but also the lymph nodes become inflamed.

Sometimes syphilitic chancres can go away on their own without treatment. However, this does not mean that the disease has gone away by itself. The disappearance of the chancre indicates that syphilis has gone into a deeper form or has found a new place to localize the infection.

A little about the main disease

Since the syphilitic chancre is the initial stage of such a sexually transmitted disease as syphilis, you should learn more about it.

Syphilis is a venereal-type infectious disease caused by the ingestion of pathogens such as treponema. They are thin spirals that can move and bend in all directions.

Microbes multiply at a temperature of +37 ° C, that is, at normal body temperature. It is noteworthy that they have a protective shell (or capsule) and feel comfortable in cold temperatures. But when boiled, treponemas instantly die, and at +60 ° C they can self-destruct after fifteen minutes.

How can you get this disease?

Methods of infection

Most often, syphilis is transmitted sexually. However, there are precedents when the disease was transmitted through a simple kiss on the cheek or as a result of the use of the same household items (towels, bed linen, toothbrush, dishes, medical instruments not subjected to special treatment). In such cases, the syphilitic chancre may appear on the arms, neck, and shoulders of an infected person.

In addition, syphilis can be contracted through a blood transfusion.

How do doctors classify skin manifestations of the disease?

Varieties of anomalies

Most often, the syphilitic chancre, which is the first sign of syphilis, has a solid base. It can appear anywhere - in the mouth, on the genitals, abdomen, hands, and so on.

Skin manifestations of the disease can be single, and can be localized in groups.

According to the depth of the lesion of the epidermis, such chancres are distinguished:

Ulcerative (relatively deep).
Erosive (located on the surface of the dermis).

According to the size of the wounds, experts distinguish the following categories of syphilitic chancres:

Dwarf (up to one centimeter inclusive).
Medium (from one to two centimeters).
Giant (up to five centimeters in diameter).

Where does it all start

How to determine that the infected person does not have an ordinary skin rash or sore, but a syphilitic chancre? First of all, you need to know that the primary manifestation of syphilis on the skin of the body looks like a slight red spot found on the skin or in the area of the mucous tissue. Therefore, it is important to take a close look at it. A syphilitic neoplasm looks like this:

The diameter varies from two millimeters to five centimeters, although sizes from one to two centimeters are most common.
The shape of the chancre is oval or round, with smooth, dense edges.
The bottom has a dark red color and firm density.
Sometimes the outer surface of the chancre has a purulent yellowish coating.
The skin around the neoplasm is most often not inflamed, does not change color and does not thicken.
If you press on the chancre from both sides, then a transparent liquid of light yellow color will come to the surface. Be careful: it contains treponema.

Progression of symptoms

For several weeks, a hard chancre may stick to the skin, and then completely disappear or scar. This means that syphilis has taken a latent form.

After this, the patient will begin to be disturbed by other symptoms, indicating a deterioration in general well-being:

Muscle or joint pain.
Numerous occurrences of syphilitic ulcers (scleradenitis).

This is due to the fact that treponemas actively develop and spread throughout the body.

Atypical (atypical) skin manifestations

Not always syphilitic chancre has the characteristics described above. In some cases, syphilis can be complicated by other infectious diseases such as gonorrhea, genital herpes, chlamydia. Then the chancres can change. The most common manifestations of syphilis on the patient's body:

Felon. It occurs on the hands, more often on the fingers of the infected. Basically, these are occupational diseases that affect gynecologists or surgeons due to careless actions or other reasons. Such neoplasms cause a lot of pain, can provoke swelling of the dermis around the wound, suppuration, and a feverish state of the patient.

Amygdalitis. In other words, a syphilitic chancre in the mouth. Affects one or two tonsils. It rarely bothers a person in the form of painful symptoms. Most often it manifests itself in an increase in one tonsil, the condition is not accompanied by an increase in body temperature, soreness of the lymph nodes.
Inductive edema. Appears on the genitals of an infected person. As a result, there are painful sensations provoked by an increase in the genital organs.
Syphiloma-herpes. Most often, such a syphilitic chancre in men manifests itself in inflammation of the head of the penis and the inner foreskin. Also, this disease is accompanied by the fact that the foreskin, moved away from the head, does not come back. Perhaps even infringement of the head by the percutaneous ring.

Such atypical manifestations of chancres can complicate the diagnosis of syphilis and lead to the rapid progression of the disease, as a result of which blood circulation is disturbed, which, in turn, can lead to tissue necrosis, gangrene, and so on.

Appearance on the genitals

Localization of syphilitic chancres in men on the head of the penis or in women on the genitals is most common. This is due to the fact that in ninety percent of cases, syphilis is transmitted sexually, that is, during sexual intercourse.

In women, the syphilitic chancre of the initial stage appears on the posterior commissure of the labia or cervix.

Not always these neoplasms look intimidating. The fact is that they can be no different from ordinary erosion or minor damage. At the same time, such chancres can hurt and bleed.

In women, syphilitic chancres in the vagina are extremely rare. But near the opening of the urethra or on the labia - quite often.

Sometimes areas of the skin located in the immediate vicinity of the genitals - the pubis, abdomen or thighs - can be affected.

Non-genital localization of syphilomas

Most often, hard chancre can be found in the oral region. Sometimes, especially at first, it is confused with candidiasis. However, with the latter disease, the erosions have whitish, loose edges, while with syphilis, the wounds are red and dense, sometimes they can be covered with a yellowish crust.

Most often, chancres are observed on the lips, mucous membranes, the tip of the tongue, less often on the gums, tonsils, and palate. Sometimes they can appear on the mucous membranes of the eyelids, most often this is associated with kissing the eyes.

There are also anal syphilomas that form in the anus and inside the rectum.

A few general words about treatment

Here it should be noted that with the appearance of skin neoplasms similar to syphilomas, it is necessary to immediately contact a specialist for the appointment of urgent and complete treatment.

The basis of drug therapy will include, first of all, the treatment of the infection that provoked the appearance of skin formations, and not their cosmetic removal.

How to detect syphilis? To do this, it will be necessary to pass the necessary blood tests, as well as to pass a smear of the chancre for examination.

How is the treatment carried out

You should also be aware that it will be necessary for both partners to carry out drug therapy at the same time.

Moreover, during the treatment period, you will need to avoid any sexual contact with anyone.

If the patient did not have permanent partners, then prophylactic treatment should be carried out for everyone with whom he had intimate contact three months before the onset of chancres. Sometimes drug therapy may be needed for partners with whom there has been intimacy for six months or more.

Also, during the treatment period, it is worth adhering to sanitary and hygienic standards as strictly as possible. This refers to the regular and thorough processing of household items, personal hygiene, and so on. It is also recommended that partners share personal items - bed linen, dishes, and so on. This is especially important when the places of manifestation of chancres are the mouth, fingers, and the like.

Medical therapy

What does the treatment for syphilis include? First of all, it is antibiotic therapy, carried out under the supervision of a knowledgeable specialist and regular tests that will show whether the treatment is effective or not.

Treponemas are very sensitive to such antibiotics as penicillin, tetracycline, cephalosporin and their derivatives. Thus, the following drugs are most often prescribed:

"Estencillin". It is usually administered as an intramuscular injection. The agent is used twice, together with 0.5% novocaine. Sometimes one injection is enough.
"Bicillin-5". It is also administered intramuscularly, twice (the period between injections is five days).
"Erythromycin". Tableted remedy, used 500 mg four times a day, half an hour before meals or one and a half hours after.
"Doxycycline". Also a tablet preparation, used four times a day, five hundred milligrams during or immediately before meals.

For local treatment, specialized ointments and gels can be prescribed. These include funds based on erythromycin (one or three percent), mercury (ten percent), synthomycin (five or ten percent) or levorin (five percent). Baths on the affected areas or lotions can also be used. In such cases, benzylpenicillin or dimexide are used, due to which the agents penetrate into the dermis and have a therapeutic effect.

If syphilitic chancres are found in the oral cavity, then in this case, the attending physician may prescribe oral rinsing with furacilin (dilute with water in a ratio of 1: 10,000), boric acid (two percent solution) or gramicidin (also two percent solution).

Of course, the specific dosage and duration of the course of a particular drug is prescribed only by the attending physician, who knows the entire clinical situation and has more detailed information. Most often, the treatment period can exceed more than two months, and in some cases it can last two years or more.

Don't Forget Immunity

Since the protective function of the body is significantly reduced with syphilis, an important part of therapy for such a disease is to increase the patient's immunity. This can be done both with the help of folk methods and pharmacological preparations.

For example, immunostimulating drugs can be prescribed, as well as vitamins and a complex of useful trace elements that help improve immunity.

Other treatment factors

An important factor in successful drug therapy is the observance of the correct lifestyle during the treatment period. First of all, you should get rid of bad habits such as smoking and alcohol abuse.

Also, attending physicians most often prescribe a certain diet for patients with syphilis. Its essence lies in the use of a large amount of proteins and minimizing the consumption of fats, especially animals.

Moreover, during the period of treatment it is very important to monitor the psycho-emotional state of the patient. A patient with syphilis should not be overstrained either morally or physically. It is recommended to avoid all sorts of loads, experiences, stress. For this, it is recommended, if necessary, to use drugs prescribed by a doctor.

We have analyzed what a syphilitic chancre looks like and how to treat it.

At the present stage, the diagnosis and treatment of syphilis is characterized by the use of new methods and highly effective drugs that prevent serious complications. The classification of the disease existing in Russia is based mainly on the epidemiological features and the specifics of the clinical manifestations of different periods of the course of the disease. Depending on this, primary syphilis, secondary and tertiary are distinguished. They, in turn, are subdivided into their respective subspecies.

The cause of the disease and its characteristics

The cause of syphilis, or the causative agent, is Treponema pallidum, belonging to the Spirochaetaecae family, which does not perceive staining. This property, as well as the presence of curls (on average 8-20 or more), which differ in width, uniformity and angle of bend, and characteristic movements (rotational, flexion, undulating and translational, like a whip in case of attachment to cells) are important for laboratory diagnostics.

The wall of pale treponema consists of biochemical components (protein, lipid and polysaccharide), which have a complex composition and have antigenic (allergenic) properties. Microorganisms multiply within an average of 32 hours by dividing into many pieces of one curl, able to pass through the bacterial filter.

The causative agent under adverse conditions can be transformed into one of 2 forms of survival. One of them is cysts, which have a stable protective shell. They also have antigenic properties and are determined by serological (immune) reactions, which remain positive for many years after the transferred early form.

The second form of existence under adverse conditions is L-forms, which do not contain a cell wall, their metabolism is sharply reduced, they are not capable of cell division, but retain intensive DNA synthesis. Under appropriate conditions for life, they are quickly restored to their usual spiral shape.

The resistance of L-forms to antibiotics can increase by several tens and hundreds of thousands of times. In addition, they do not have antigenic properties or the latter are very reduced. In this regard, by means of classical serological reactions, the causative agent of the disease cannot be detected. In this case (in the later stages), it is necessary to carry out RIF (immune fluorescence reaction) or RIT (treponema immobilization reaction).

Pale treponema is characterized by low resistance to the influence of the external environment. The optimal conditions for its existence are high humidity and a temperature of 37˚C. Outside the human body at a temperature of about 42˚C, it dies after 3-6 hours, and at 55˚C - within 15 minutes.

In blood or serum at 4˚C, the duration of its survival is at least 1 day. For this reason, fresh donated blood and its preparations are currently not used, despite laboratory control. A significant absence of treponema in canned blood is noted after 5 days of storage.

The microorganism retains its activity on various objects only until they dry out, quickly dies under the influence of acids and alkalis and does not survive in products such as vinegar, sour wines, sour milk and kefir, kvass and sour carbonated drinks (lemonade).

Ways of infection and mechanisms of development of primary syphilis

The source of infection is only a sick person. The main conditions for infection are the presence of even imperceptible damage to the stratum corneum of the skin or the integumentary epithelial layer of the mucous membrane and the introduction of at least two pathogens through them into the body. According to some clinicians, mucosal damage is not necessary.

There are two ways of getting syphilis:

direct - sexual contact (most often - 90-95% of cases), kissing, biting, breastfeeding, caring for a child or a sick person, professional (medical personnel when examining patients, operations and manipulations, attending childbirth, with musicians through common wind instruments, etc.), intrauterine infection of the fetus, transfusion infection (transfusion of blood and its preparations);
indirect - infection through various wet common items, linen, etc. in everyday life, in kindergartens, military units, hairdressers and beauty salons, in medical institutions (mainly dental and gynecological rooms).

Men suffer from primary syphilis 2-6 times more often than women. In the latter, secondary and latent (latent) syphilis is more common, which are often discovered by chance only during examinations and mandatory serological tests in gynecological consultations and departments.

The first clinical symptoms of primary syphilis appear on average 3-4 weeks after the pathogen enters the damaged skin surface or mucous membranes (incubation period). This period can be reduced to 10-15 days or increased to 2.5-3 months, and sometimes up to six months, especially when taking low doses of antibiotics. The decrease in the duration of the incubation period is affected by:

senile or early childhood;
unfavorable living and working conditions;
severe psycho-emotional stress, mental or physical overwork;
malnutrition;
concomitant chronic diseases, diabetes mellitus;
acute and chronic infectious diseases;
chronic intoxications (industrial, nicotine, alcoholic, narcotic);
re-infection through repeated sexual contact with sick partners.

An increase in the duration of the incubation period of primary syphilis is observed in people with high protective properties of the body, when taking antibiotics or antibacterial agents for any inflammatory diseases, in the presence of genetic immunity to the causative agent of the disease (very rarely).

After pale treponema enters the body, their intensive division (reproduction) occurs at the site of introduction, where the first and main symptom of the primary period of syphilis, syphiloma, develops. Pathogenic microorganisms quickly spread by lymph and blood to all tissues and organs. A small number of them penetrate into the lymph of the perineural (around the nerve fibers) spaces and along them into the parts of the central nervous system.

This process is accompanied by a change in the reactivity of the whole organism, that is, an allergic reaction of tissues, and in parallel - an increase in immune defense against an infectious agent. Allergy and immune response are two phenomena of a single universal biological reaction of the body under the influence of an infectious agent, which subsequently manifests itself as clinical symptoms of primary syphilis.

Clinical picture of the disease

A specific sign of primary syphilis is a positive laboratory serological reaction. However, the entire incubation period and the first week, even up to the 10th day of the first period, it remains negative. Moreover, in some patients it is negative throughout the disease, which greatly affects the timely diagnosis and treatment of syphilis. In recent years, this has been observed in an increasing number of patients.

The results of the serological reaction are taken into account in the classification, in which primary syphilis is divided into:

seronegative;
seropositive;
hidden.

Syphilis primary seronegative- this is only such a form of the disease, which throughout the entire period of the course of treatment is characterized by persistent negative results of standard serological tests carried out regularly and at least every 5 days. This does not take into account the results of immunofluorescence and Colmer reactions, which are a modification (cold mode) of the classical Wasserman serological test. If classical reactions gave at least one weakly positive result, primary syphilis is classified as seropositive.

After the end of the incubation period, two main signs of the disease develop:

Primary syphiloma, or hard chancre, primary sclerosis, primary ulcer, primary erosion.
Damage to the lymphatic vessels and nodes.

Roseolous rash in primary syphilis does not occur. Sometimes there are isolated cases of the so-called "headless" syphilis, when the latter manifests itself already in the secondary period (bypassing the primary) 3 months after infection. A symptom of secondary syphilis is a rash. This occurs mainly as a result of deep injections with infected needles, intravenous transfusion of infected blood and its preparations, after operations or manipulations with an infected instrument.

Primary syphiloma

Hard chancre occurs on average in 85% of infected people and is an erosive or ulcerative formation on the skin or mucous membranes at the site of inoculation (implementation) of pale treponema. This is not a true morphological element of the disease. It is preceded by "primary sclerosis", which in most cases goes unnoticed not only by the patient himself, but also by the dermatologist. This change begins with the appearance of a small spot of red color due to capillary expansion, which, within 2-3 days, transforms into a painless hemispherical papule (dense formation without a cavity, slightly rising above the skin) with a diameter of several millimeters to 1.5 cm, covered with a small number of scales of the horny epithelium.

Over several days, peripheral growth of the papule, thickening and crusting occur. After spontaneous rejection or removal of the latter, the disturbed skin surface is exposed, that is, erosion or a superficially located ulcer with a seal at the base, which are the chancre.

Syphiloma is rarely painful. More often it does not cause any subjective sensations. After reaching a certain size, it is not prone to further peripheral growth. The average diameter of the chancre is 1-2 cm, but sometimes there are "dwarf" (up to 1-2 mm) or "giant" (up to 4-5 cm) formations. The first are formed in the case of penetration of treponema into the depth of the hair follicles and are localized in those areas of the skin in which the follicular apparatus is well developed. They are very dangerous because they are almost invisible and therefore are a source of infection. Large elements are usually located on the face, thighs (inner surface), on the forearm, in the lower parts of the skin of the abdomen, on the pubis.

Primary ulcer or erosion can be oval or round geometrically regular shape with even and well-defined borders. The bottom of the formation is located at the level of the surface of the surrounding healthy skin or somewhat deepened. In the latter version, the chancre acquires a "saucer-shaped" shape.

Its surface is smooth, bright red in color, sometimes covered with a dull grayish-yellow bloom. Against this background, there may be petechial (pinpoint) hemorrhages in the center. Sometimes plaque is located only in the central sections of the ulcer and is separated from healthy areas of the skin by a red rim.

In open areas of the body, the ulcerative surface is covered with a dense brownish crust, and on the mucous membranes - with a transparent or whitish serous discharge, which gives it a kind of "lacquer" sheen. The amount of this discharge increases sharply when the surface of the chancre is irritated. It contains a large amount of the pathogen and is used for smears for microscopic examination.

Primary syphiloma is called a "hard" chancre due to the fact that it is delimited from the surrounding healthy tissues at the base by a soft elastic seal that extends beyond the ulcer or erosive surface by several millimeters. Depending on the shape, three types of this seal are distinguished:

nodular, having the appearance of a hemispherical formation with clear boundaries and deeply penetrating into the tissues; such a seal is determined during a routine visual examination and is called the "visor" symptom; as a rule, it is localized in the region of the coronal sulcus and on the inner surface of the foreskin, which violates the displacement of the latter and leads to phimosis;
lamellar - comparable to a coin at the base of a syphiloma, placed on the labia majora, the stem section of the penis or in the region of the outer surface of the foreskin;
leaf-shaped - not a very solid base, similar to a thick paper sheet; occurs when localized on the glans penis.

Varieties and various options for hard chancre in primary syphilis

Special varieties of primary education are:

Combustiform (burn) hard chancre, which is an erosion on a leaf-like base with a tendency to peripheral growth. As erosion increases, the correct outlines of its boundaries are lost, and the bottom acquires a granular red color.
Folman's balanitis (symptom complex) is a rare clinical variety of chancre in the form of multiple small erosions without pronounced compaction. Its localization is the glans penis and labia majora. The development of this symptom complex in primary syphilis is facilitated by the use of oral antibiotics during the incubation period or the application of external agents with antibiotics to syphiloma at the initial stage of its development.
Chancre herpetiformis, which has a significant resemblance to genital herpes. It is a grouped small erosion with a fuzzy compaction at the base.

Depending on the anatomical specifics of the location of the primary syphiloma, different options for its formation are possible. So, on the head of the penis, it is expressed by erosion with a slight lamellar base, in the region of the coronal sulcus - a large ulcer with a nodular seal, in the region of the frenulum of the penis, it looks like a strand with a dense base, bleeding during erection. When localized on the distal border of the foreskin, syphilomas are usually multiple and linear in nature, and on the inner sheet it looks like an infiltrate like a rolling plate (“hinged” chancre); removal of the head is difficult and is accompanied by tears.

Localization of syphilomas in primary syphilis

Primary syphilomas can be single or multiple. The latter are characterized by simultaneous or sequential development. The condition for their simultaneous development is the presence of multiple defects of the mucous membrane or skin, for example, with concomitant skin diseases accompanied by itching, injury or cracks. Successively occurring chancres vary in degree of density and size and are observed during repeated sexual intercourse with a sick partner.

Recently, bipolar formations have become more common, that is, on two parts of the body distant from each other (on the external genital organs and on the mammary gland or on the lips), and “kissing” ulcers - in the area of \u200b\u200bcontacting surfaces of the labia minora, as well as chancre - "imprints" on the penis in the crown zone, which very often lead to the development of balanoposthitis. Such forms are accompanied by a shorter incubation period and an earlier appearance of seropositive reactions.

Localization of primary syphiloma depends on the method of infection. Most often it appears on the external genitalia. On the mucous membranes of the genital organs, the chancre can be located in men in the area of the external opening of the urethra. In these cases, there is an increase in inguinal lymph nodes, painful urination, serous - spotting, which is often confused with gonorrhea. As a result of the healing of the ulcer, a stricture (narrowing) of the urethra may form.

With primary syphilis in women, erosion can form on the mucous membranes of the cervix - in the region of the upper lip (more often) of the vaginal part of the cervix, in the area of the external pharynx of the cervical canal. It has the appearance of a round limited erosion with a bright red shiny surface or covered with a grayish-yellow coating and serous or serous-purulent discharge. Much less often, the primary formation occurs on the mucous membrane of the walls of the vagina.

With perverse sexual intercourse on any part of the skin and mucous membranes, extragenital (extra-sexual) single and multiple syphilomas can develop, which occurs (according to various sources) in 1.5-10% of cases of infection. For example, it may occur:

primary syphilis on the face (in the area of the red border of the lips, more often on the lower, in the corners of the mouth, on the eyelids, chin);
in the folds of the skin located around the anus (often resembles a normal crack);
on the skin of the mammary glands (in the areola or nipples);
in the armpit, on the navel, on the skin of the second (more often) phalanx of the fingers.

Extragenital hard chancre is characterized by more rapid formation of erosion or ulcers, soreness, prolonged course and a significant increase in peripheral lymph nodes.

During oral sex, primary syphilis of the oral cavity develops with localization in the region of the middle 1/3 of the tongue, on the tonsils, on the mucous membrane of the gums, at the neck of one or more teeth, on the back of the throat. In cases of anal sex in both men and women, primary syphiloma may occur not only on the skin in the anus, but, in more rare cases, on the mucous membrane of the lower rectum. They are accompanied by pain during the act of defecation, bloody discharge mixed with mucus or pus. Such syphilomas often have to be differentiated from an ulcerated rectal polyp, hemorrhoids, and even a malignant neoplasm.

Damage to the lymph nodes and lymphatic vessels

The second main symptom of primary syphilis is lymphadenitis (enlargement) of regional lymph nodes, or the accompanying "bubo", scleradenitis. It is important in the differential diagnosis of primary syphilis and persists for 3 to 5 months even with adequate specific therapy and secondary syphilis.

The main symptom of syphilitic scleradenitis is the absence of acute inflammation and pain. As a rule, a symptom called the Rikor Pleiad is found. It is expressed in an increase in several lymph nodes up to 1-2 cm, however, the node closest to the syphiloma is large in comparison with those more distant from it. The lymph nodes show no signs of inflammation. They have a round or oval shape and a densely elastic consistency, they are not soldered to each other and to the surrounding tissues, that is, they are located in isolation.

Scleradenitis develops, as a rule, at the end of the first week after the formation of syphiloma. With an extension of the incubation period, which occurs in cases of concomitant intoxication of the body, taking antibacterial, antiviral or immune drugs, etc., lymphadenitis may appear before the formation of the chancre or simultaneously with it. Lymph nodes can increase from the location of the primary focus, from the opposite (cross) or from both sides.

If the primary chancre is located in the vulva, the inguinal nodes react, on the chin and lower lip - submandibular and cervical, in the areas of the upper lip and tonsils - submandibular, anterior and cervical, on the tongue - sublingual, in the region of the outer corners of the eyes or on the eyelids - anterior, in the region of the mammary glands - parasternal and axillary, on the fingers of the hands - elbows and axillaries, on the lower extremities - inguinal and popliteal. Regional lymphadenitis during external examination is not detected in the case of localization of syphiloma on the walls of the vagina, cervix or rectum, since in these cases the lymph nodes of the small pelvis react.

By the end of the primary stage of syphilis, syphilitic polyadenitis develops, that is, a widespread increase in the lymph nodes of the submandibular, cervical, axillary, inguinal, etc. Their magnitude is less than with regional lymphadenitis, and the farther from the primary focus, the smaller they are. Polyadenitis, like regional lymphadenitis, persists for a long time even with the use of specific therapy.

Syphilitic damage to the lymphatic vessels (lymphangitis) is not an obligatory symptom. In relatively rare cases, it is manifested by the defeat of small lymphatic vessels mainly in the area of the primary focus and is accompanied by painless swelling of the surrounding tissues, which persists for several weeks. Larger affected lymphatic vessels may be seen as firm, painless subcutaneous tourniquets.

Complications of primary syphilis

The main complication is the transition of the disease to the secondary stage in the absence of specific adequate therapy. Other complications are associated with primary syphiloma:

Ulcer formation

Erosion usually forms first. An ulcer in some cases is already considered a complication. Its development is facilitated by factors such as self-use of external irritating drugs, violation of hygiene rules, childhood or old age, concomitant chronic diseases, especially diabetes mellitus, anemia and chronic intoxication that weaken the body.

Balanitis (inflammatory process of the head) or balanoposthitis (inflammation in the area of the inner leaf of the foreskin, as well as the head)

They arise as a result of the addition of purulent or other conditionally pathogenic flora, including fungal ones, in case of non-observance of personal hygiene, mechanical damage or irritation, weakened reactivity of the organism. These complications are manifested in acute inflammatory processes around the chancre - redness, the appearance of additional small erosive areas, tissue swelling, soreness, purulent or purulent bloody discharge. All this may be similar to the usual banal balanoposthitis and makes it difficult to diagnose the underlying disease.

Phimosis (inability to move the foreskin to remove the head of the penis) and paraphimosis

Phimosis occurs as a result of swelling of the glans and foreskin or scarring of the foreskin after the ulcer has healed. These changes lead to a narrowing of its ring and prevent the removal of the head. With forcible removal, an infringement of the head (paraphimosis) occurs, which, if timely assistance is not provided, leads to its necrosis (death).

Gangrenization

A rare complication of chancre that occurs on its own or as a result of activation of saprophytic spirochetes and bacilli (fusispirillosis infection) with weakened immunity. In addition, staphylococcal and streptococcal infections also join them. The complication is manifested by rapidly spreading necrosis along the surface and deep into the syphiloma. A scab of a dirty yellowish-gray or black color appears on the surface. When it is removed, an ulcerative surface with bright red granulations is exposed.

Gangrenization develops only within the syphilitic ulcer, and after healing, following the rejection of the scab, a scar is formed. Gangrenization is accompanied by a deterioration in the general condition, fever and chills, headache, the appearance of soreness in regional lymph nodes, and sometimes hyperemia (redness) of the skin above them.

Fagedinism

A rarer but more severe complication of primary syphilis caused by the same bacterial flora. It is characterized by the spread of tissue necrosis not only within the boundaries of the ulcerative surface, but also with the involvement of healthy tissues surrounding it. In addition, necrosis after rejection of the scab does not stop. Gangrene is increasingly spreading to healthy areas, resulting in severe bleeding, destruction of the wall of the urethra, followed by its cicatricial narrowing, complete destruction of the foreskin and even the head of the penis. Fagedinism is accompanied by the same general symptoms as with gangrenization, but more pronounced.

Diagnostics

As a rule, establishing a diagnosis with the appearance of a characteristic syphiloma does not cause any difficulties. Nevertheless, its laboratory confirmation is necessary by microscopic detection of pale treponema in a smear or scraping from an erosive (ulcerative) surface or in a punctate from a regional maximally large lymph node. Sometimes these studies have to be performed for several days before the onset of the epithelialization process. In addition, sometimes (relatively rarely) it becomes necessary to conduct a histological examination of tissues from a hard chancre.

Classical serological tests become positive only by the end of the 3rd week or by the beginning of the next month of illness, so their use for early diagnosis is less important.

Differential diagnosis of primary syphilis is carried out with:

traumatic erosion of the genital organs;
with banal, allergic or trichomonas balanitis and balanoposthitis that occurs in people who do not follow normal hygiene;
with gangrenous balanoposthitis, which can develop independently or as a complication of the diseases listed above;
with soft chancre, genital herpetic lichen, scabies ecthyma, complicated by staphylococcal, streptococcal or fungal infection;
with ulcerative processes caused by or gonococcal infection;
with acute ulcers of the labia in girls who are not sexually active;
with malignant neoplasm and some other diseases.

How to treat primary syphilis

The disease is completely curable if timely adequate therapy is carried out in the early stages, that is, during the period of primary syphilis. Before and after the course of treatment, studies are carried out using CSR (a complex of serological reactions), including a microprecipitation reaction (MRP).

Treatment of primary syphilis is carried out with penicillin and its derivatives (according to the developed schemes), since this is the only antibiotic to which the causative agent of the disease develops resistance much more slowly and weakly compared to the others. In case of intolerance to antibiotics, penicillin derivatives, others are selected. The sequence of decreasing effectiveness of the latter: Erythromycin or Carbomycin (macrolide group), Chlortetracycline (Aureomycin), Chloramphenicol, Streptomycin.

For outpatient treatment, long-acting penicillin preparations are used:

foreign production - Retarpen and Extencillin;
domestic preparations of bicillin - Bicillin 1 (one-component), which is a dibenzylethylenediamine penicillin salt, Bitsillin 3, including the previous one, as well as novocaine and sodium salts of penicillin, and Bitsillin 5, consisting of the first and novocaine salts.

In the conditions of inpatient treatment, mainly the sodium salt of penicillin is used, which is characterized by rapid excretion and provision of an initial high concentration of the antibiotic in the body. If it is impossible to use penicillin derivatives, alternative antibiotics (listed above) are used.

Unfortunately, not everyone tries to protect themselves from various diseases. It is for this reason that some people become victims of the most dangerous diseases. Some of these diseases can even lead to death. One such dangerous disease is syphilis. On the initial development of syphilis on the body of a sick person appear chancre.

What is primary syphilis?

Primary syphilis called the initial stage of syphilis, which develops after infection with pale treponema. Primary syphilis begins with formations on the skin, as well as with penetration inside. With primary syphilis, a hard chancre appears on the body. These formations can form both on the skin and on the mucous membranes.

Currently, modern medicine has identified some differences regarding the clinical picture of primary syphilis, compared with those manifestations that were noticed before.

For example, earlier at the initial stage of development of syphilis, the chancre was formed in a single amount in almost 90% of patients. Currently, chancres began to appear on the skin in the amount of two formations. In addition, the chancres began to increase in size.

In another article on our site, we discussed.

Solid syphilitic chancre - the initial stage of syphilis

Primary chancre at the very beginning, it looks like a red spot, which eventually turns into erosion.

The main signs of a hard syphilitic chancre:

The diameter of the spot on the skin or mucous membrane can reach 5 cm.
The shape of the spot is oval.
Education has clear boundaries.
The color of the spot is red or burgundy.
The presence of yellow purulent plaque.

Hard syphilitic chancre is never accompanied by pain or itching. Many people simply do not notice it because of this on their body. If you press lightly on the stain from the side, then a yellow liquid may stand out from it.

Healing of a hard chancre occurs within a month. After that, this formation on the body does not leave any visible marks. But, despite this, it is worth noting that the disappearance of a hard chancre indicates that the disease can take a latent form.

Among women

Syphilitic hard chancre in women is a very dangerous venereal disease. Even at the initial stages of its development, syphilis is a serious infection for sexual partners, and at an advanced stage, the disease can cause death.

In order for the treatment to give some positive result, the chancre in a woman must be identified at the initial stages of its formation.

The period of manifestation of chancre after infection usually takes about 3 weeks. In women, a hard chancre may form on the labia or clitoris. However, it is much more difficult to detect a formation if it is localized inside the vagina. Such a chancre can be noticed only by chance during a gynecological examination. It is for this reason that you should not neglect regular visits to a female doctor.

In men

Solid syphilitic chancre in men, as a rule, manifests itself in the area of \u200b\u200bthe genital organ. To be more specific, it affects the head of the penis, the coronal sulcus and the scrotum.

If a man is a supporter of non-traditional sexual orientation, then formations may appear in the anus and in the mouth. In size, chancre in men can be both miniature and giant. Moreover, it is worth noting that the most contagious are miniature chancres, which are only a few millimeters in diameter.

The first symptoms of a hard syphilitic chancre may appear both 2 weeks after infection and 3 months later. A hard chancre is formed, usually in the place that was subject to the introduction of pale treponema, the main provocateur of the disease.

The most common sites of infection are the genital organs of a person. However, at present, more and more cases have begun to occur when the chancre appears on the abdomen, thighs, face and fingers.

External distinguishing features of a solid syphilitic chancre:

Formation of fleshy erosion.
The diameter of the formation can reach several cm.
Erosion has raised edges.
The stain has a burgundy or red tint.
A liquid is released from erosion, which externally makes it lacquered.
The base of the formation is a dense infiltrate.

A photo

Types of syphilitic chancre

As a rule, syphilitic chancre is divided into the following types, which differ in symptoms:

Giant hard chancre most often formed at the site, which is characterized by abundant fatty tissue under the skin. The size of such a chancre can reach the size of a child's palm.
Dwarf hard chancre differs in its size, which can reach the size of a poppy seed.
Diphtheritic chancre differs in that its surface is covered with a gray film, like diphtheria. This species is very common.
Crusted hard chancre It is formed on those parts of the body where the discharge easily dries out (nose, lips, face).
The slit-like chancre looks like a crack. Most often, this type is formed in the corners of the mouth, between the fingers and in the anus.

It is a rather dangerous disease that is sexually transmitted. One of the primary signs of the disease can be a syphilitic chancre. This neoplasm of a benign nature appears on the human body after a few weeks of the disease. In the absence of proper treatment, syphilitic chancre can turn into erosion.

Types of syphilitic chancres

There are many characteristics that describe the chancre in syphilis. Depending on the criterion, several classifications and types of chancres are distinguished. Depending on the depth of the skin lesion, ulcerative (rather deep) and erosive (less deep, located on the surface of the skin) are distinguished. Chancres can be located in a single instance, or they can be represented by whole groups of neoplasms.

The sizes of chancres with syphilis may vary. There are the following sizes of neoplasms in venereal disease:

Dwarf (size does not exceed one centimeter);
Medium (size can reach two centimeters);
Giant (can grow up to five centimeters in diameter).

Not many people know that a disease such as syphilis can provoke the appearance of hard and soft chancres. You need to know what a hard chancre looks like. It is he who occurs as the primary symptom of syphilis. Chancre can affect almost all parts of the human body.

Its distinguishing characteristic is a geometrically correct area on the skin with a whitish film on top. This film contains a huge variety of causative agents of syphilis.

With syphilis, atypical forms of chancre can develop:

Chancre felon. A similar type of chancre is located in the area of \u200b\u200bthe hands and fingers. Quite often, chancres on the index and thumbs appear in gynecologists and surgeons as an occupational disease. Panartium is a rather painful neoplasm;

Chancre amygdalite. Chancres of a similar nature appear on one of the tonsils in the throat of a person with syphilis. A neoplasm of such a plan practically does not hurt and does not bother a person. The only difference is that the affected tonsil is significantly different from the healthy one in size. Chancre amygdalitis can affect the health of the pharynx;

Inductive edema. Such a neoplasm appears on the genitals in women and men. The tissues of the genital organs become denser, swell and increase in size. At the same time, there are no unpleasant and painful sensations.

The first signs of the appearance of a syphilitic chancre

Syphilis is a dangerous disease not only for health, but also for human life. If left untreated, the disease becomes chronic, constantly tormenting the patient with remissions, until it leads to death. The bacteria that causes syphilis cause symptoms of the disease. As a rule, they appear two to three weeks after infection.

Chancre can appear on the following areas of the human body:

Sex organs. The appearance of a chancre on the genitals of a person infected with syphilis is most common. The causative agent of both the underlying disease and its consequences is pale treponema. Transmission of the pathogen occurs through sexual contact with the carrier. If there are already injuries on the genitals of a woman or a man, the pathogen quickly penetrates into it and forms a chancre in a few weeks;

Large skin areas. Giant syphilitic chancres, which reach five centimeters in size, are most often located on the hips, back and abdomen. They grow quite quickly and spread throughout the body, they can form whole groups of neoplasms;
Hands and fingers. Neoplasms of a venereal nature on the hands occur quite rarely. Most often, their appearance is provoked by infection not through sexual contact, but when working directly with the pathogen. The risk zone for such a course of the disease includes doctors and laboratory assistants who work closely with the infected and their biological material.

In rare cases, syphilitic chancre can appear on the mucous membrane, on the face and other parts of the body.

Visual signs of chancre

The period from the appearance of the first signs of neoplasm to the formation of a full-fledged hard chancre can be about a month. In very rare cases, the first signs of the disease appeared already seven to ten days after the entry of treponema into the human body. On the contrary, a long absence of the primary symptom can provoke the use of antibiotics, which kill some of the bacteria or slow down their vital activity.

The process of formation of a syphilitic chancre:

Solid syphilis chancre is formed two to three weeks after the onset of treponema in the human body;
Regional scleradenitis develops. It is characterized by the following symptoms:

The appearance of small formations in the region of the lymph nodes, which are located near the chancre;
On palpation, the formations have a heterogeneous structure and are quite dense;
The nodes can move under the skin when exposed to them;
One of the nodes is usually larger than all the others;
The skin in the area of formation of nodes does not change.

A few weeks after the formation of the chancre, you can test for syphilis. The serological reaction in the presence of the pathogen in the body will be positive.

Visually, a syphilitic chancre can be compared with a circle. It has dense and even bases. Its edges completely coincide with the geometric figure. When visually assessing the chancre, its similarity to nodules and small cartilages is distinguished. When located on areas of the body covered by clothing, the chancre has a bright red or slightly purple hue. Constant contact with the external environment causes the chancre to darken to brown.

The neoplasm that causes primary syphilis does not differ in specific symptoms. It does not hurt, does not itch, does not cause any discomfort. In many cases, the symptom of "weeping chancre" is present. In this case, there is a release of a cloudy dense liquid with an external effect on the chancre.

Treatment of syphilitic chancre

Before you start treatment, you need to know that chancre is a condition that is not an independent disease, but only a symptom of syphilis. Its appearance is caused by a disease that needs to be urgently treated.

Chancre is the primary manifestation of the disease. If left untreated, it can develop into a painful ulcer and cause infection of the entire body, and then death.

Every day, chancres must be treated with an antiseptic so that secondary infection does not connect to damaged skin. To do this, any antiseptic liquid is applied to a sterile dressing and attached to the formation on the skin. Giant chancres can be washed and then wrapped with a bandage.

In the treatment of the disease, it is necessary to use complex drugs that allow you to get rid of the cause and remove the symptoms of the disease. The composition of the treatment includes the following drugs:

Antibacterial ointments and gels;
Injections and injections of drugs against syphilis.

Antibiotics are the mainstay of treatment for syphilis. For sexually transmitted diseases, oxacillin, penicillin and ampicillin can be used. With proper treatment, small chancres completely disappear after two weeks of antibiotic use, giant ones after a month.

Even with the use of a wide range of antibiotics, the human body is not able to cope with the disease alone. To cure syphilis faster, it is necessary to use drugs that form a person's immunity. A sexually transmitted disease can significantly reduce the body's immune defenses and cause secondary infection.

Syphilitic chancre does not require surgical removal. "Cutting out" the neoplasm will not affect the disease in any way. A complete cure for chancre can be achieved only after defeating syphilis. Already in the first days of effective therapy, the chancre begins to gradually turn pale and decrease, and then completely disappears. If you do not injure the chancre at the site of its formation, there will be no trace. An exception may be the genitals, on which small light marks may form.