Syphilitic chancre: features of the disease. Chancre in men and women photo initial stage of syphilis

The primary period of syphilis develops 3-4 weeks after infection. In terms of duration, this is the longest short period(6-8 weeks) disease. Characterized by benign course, since the process is limited to damage to the skin and, less often, mucous membranes in the absence of practically functional and organic changes in the internal organs, systems, tissues and musculoskeletal system. Active manifestations are monomorphic, few in number, with predominant localization in the genital and perigenital areas. Manifested by the development of hard chancre, regional scleradenitis, lymphangitis and positive classical serological reactions. Finally, this is the most favorable period for treating the disease.

Chancre(ulcus durum). Synonyms: primary syphiloma, primary sclerosis, primary affect. From the moment of formation of hard chancre begins primary stage syphilis, which usually lasts 6-8 weeks.

At the site of introduction of treponema pallidum into the skin or mucous membrane, after 3-4 weeks a erosion or superficial ulcer(the first sign of syphilis). Initially, a clearly limited round erythema with a diameter of 0.7-1.5 cm appears, does not cause subjective sensations and quickly (after 2-3 days) turns into a flat papule with slight peeling and slight compaction of its base. After a few days, erosion often appears on the surface of the papules, less often an ulcer with a compacted base. Erosive chancre forms in 55-60% of patients, ulcerative chancre - in 40-45%. The resulting chancre increases in size within 1-2 weeks, then after 4-5 weeks, even without treatment, the erosion epithelializes, and the ulcer scars after 6-8 weeks.

Erosive chancre has a round or oval shape 0.8-1.6 cm in size. Its bottom is bright red (the color of fresh meat) or dirty gray (the color of spoiled lard), the edges are clearly defined, not undermined, are flush with the skin, without signs of acute inflammation periphery. The discharge from the surface of the erosion is serous, transparent, opalescent, in small quantities. The bottom of the erosion is smooth and shiny. At the base of the chancre, a clearly limited leaf-shaped (resembles a piece of thick paper embedded in the tissue), or lamellar (resembles the consistency of flat cartilage), or nodular (hemispherical node, reminiscent of the consistency of cartilage) non-painful compaction of dense elastic consistency is palpable. To determine the compaction, the base of the erosion is grasped with two fingers, slightly lifted and squeezed.

After epithelialization, the chancre remains temporarily age spot, then disappearing without a trace. The infiltrate at the base of the erosion persists for several weeks and sometimes months, followed by complete resorption.

Ulcerative chancre - a deeper skin defect (within the dermis), which develops more often in weakened individuals suffering from chronic somatic, infectious diseases and alcoholism, as well as in patients as a result of irritant therapy and the addition of a secondary infection with erosive chancre. The ulcer has a saucer-shaped shape with sloping edges, regular outlines, without acute inflammatory phenomena in the circumference. Its bottom is often dirty yellow, sometimes with small hemorrhages; The discharge is more abundant than with erosive chancre. The compaction at the base of the ulcer is more pronounced, nodular, and painless. The ulcer heals as a rounded scar with flat surface, hypochromic, with a narrow hyperchromic rim along the periphery.

Chancre most often ranges in size from a lentil to a ten-kopeck coin. Sometimes it reaches the diameter of a five-kopeck coin (giant chancre) or does not exceed the size of a pinhead (2-3 mm) (dwarf chancre). Chancres located in the pubic area, lower abdomen, chin and on inner surface The hips are often gigantic, with a pronounced thickening at the base. Sometimes the erosion may increase along the surface, the bottom becoming dark red and granular with slight lamellar compaction at the base, resembling a burn. This type of primary sclerosis is called burn chancre (ulcus durum combustiforme).

The number of chancre varies from 1 to 50 or more. Multiple chancres are observed in 50-61% of patients with primary syphilis. They arise as a result of simultaneous penetration of the pathogen into the skin and mucous membranes in several places or. due to successive re-infections for the first 10-14 days, until infectious immunity has developed.

Primary syphiloma may appear on the skin and mucous membranes in any area, but more often on the genitals: in men - on the penis, scrotum, less often on the skin of the pubis, inner thighs; in women - on the labia majora and minora, clitoris, frenulum, cervix (11 - 12% of cases) and extremely rarely on the wall of the vagina. Therefore, according to localization, Fournier divided chancre into genital, extragenital and perigenital.

Extragenital chancre most often localized on the mucous membranes of the lips, gums, tongue, tonsils, soft palate, less often the cheeks and nose, on the skin of the thighs, abdomen and other parts of the body. The same person may simultaneously develop chancre on the genitals and any other area of ​​the skin or mucous membranes. The combination of genital and extragenital location of primary syphilomas is called bipolar chancre. It is rare. Some features are noted during the course of syphilitic infection with bipolar chancroid: shortening incubation period, earlier positivity serological reactions with primary syphilis, shortening to 15-20 days primary period syphilis, the sequential occurrence of genital and extragenital chancre in the early formation of polyadenitis, the appearance of baldness, etc.

Clinical manifestation of chancroid depends on the localization of the process and anatomical features affected areas. On the head of the penis, the chancre is often erosive, not large sizes, regular outlines, with a slight lamellar seal; in the head groove - ulcerative, large in size, with a strong infiltrate at the base; in the area of ​​the frenulum of the penis - longitudinal shape, bleeds during erection, with compaction at the base in the form of a cord; along the edge of the foreskin - chancre with a linear arrangement, multiple, erosive; on the inner layer of the foreskin - a seal in the form of a visor and the presence of a symptom of “tarsal cartilage” (when, due to bleeding due to pressure, the chancre looks like tarsal cartilage upper eyelid); on the crown of the head, the chancre is shaped like a swallow's nest.

Approximately 6.9% of patients have chancroid endourethral location funnel shaped. It is significantly compacted, painful on palpation and during urination, with scanty serous-bloody discharge. During healing, cicatricial narrowing of the urethra may occur.

Chancre in area anus , located in folds, has the appearance of a crack or a rocket shape with slight compaction at the base. It is often painful on palpation and often bleeds during bowel movements. Primary sclerosis, located in the depths of the anal folds of the mucosa, becomes visible when the folds are straightened and also has a rocket-shaped, slit-like shape, and when located in the area of ​​the internal sphincter - oval.

Erosive chancre predominates (about 79%), less often ulcerative chancre. When hard chancre is localized on the rectal mucosa treponema pallidum is detected only after thorough cleaning of the surface of the chancre from remnants of intestinal contents.

In women, in the area of ​​the labia majora, erosive chancre, sometimes indurative edema, is mainly observed; at the entrance to the vagina - chancre is mostly small in size. On the cervix (8-12% of cases), chancre most often has the character of erosions of oval or round shape, sometimes ring-shaped or crescent-shaped, intensely red in color, with a smooth bottom, sharp boundaries, with scanty serous or serous-purulent discharge. They are most often located on the front lip, usually single and erosive.

In the area of ​​the nipple of the mammary gland single chancre predominates in the form of erosions with lamellar compaction at the base, covered with a crust, crescent-shaped, and when located in the folds of the skin and at the base of the nipple, they look like a fissure-shaped ulcer of a crescentic shape. When localized on the red border of the lips, chancre predominates in the form of erosion or ulcer, covered with a tight crust, very reminiscent herpetic lesions. In some patients, the chancre hypertrophies and 4 painful cracks appear. When located in the corners of the mouth, the chancre has a slit-like shape with inverted, non-joining, dense edges. Chancres of the lips are accompanied by a pronounced increase in the submandibular and mental lymph nodes.

Chancres on the tongue in nature they can be erosive (the bottom is smooth, shiny, bright red, with a lamellar compaction) and ulcerative (saucer-shaped, with significant compaction). Sometimes the primary affect manifests itself in the form of a linear fissure or sclerosis of the tip of the tongue.

Chancres of the tonsils represent a typical erosion or ulcer located on the compacted tonsil, without signs of inflammation. This may cause pain or difficulty swallowing. The gum chancre is located at the neck of the tooth and has a crescent shape.

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Chancre is a symptom primary syphilis. It is also called primary syphiloma or erosion. Hard chancre appears in men and women approximately three weeks after the introduction of the causative agent of the disease, Treponema pallidum, into the body. Its symptoms are erosive or ulcerative formations on the skin or mucous membranes.

Chancre has the following features:

• characterized by limited localization;
• does not affect the internal organs and systems of the body;
• responds well to treatment.

Hard chancre gets its name from the type of base of the ulcer or erosion formed. The duration of primary syphiloma is six to eight weeks.

Localization

The localization of primary syphiloma can be absolutely any. Hard chancre in humans appears directly at the site of penetration into human body Treponema pallidum through certain time after infection. Its most common location is the external genitalia - in women the labia, clitoris, in men the head, base and shaft of the penis, the outer or inner layers of the foreskin. In some cases, chancre forms on the internal mucous membranes: in the urethra in men, on the walls of the vagina or cervix in women.

In ten percent of all cases, an extragenital location of the chancre is observed. Chancre in women and men can be localized:

• V oral cavity;
• on the tongue;
• on the edge of the lips;
• on the tonsils in the throat;
• on the mammary glands of women.

Symptoms

Externally, chancre looks like a reddish spot with clearly defined, smooth edges, up to 1.5 centimeters in size. It has the shape of a geometrically regular circle or oval. Sheer or undermined edges indicate a bacterial complication.

Symptoms of chancroid are only external. It does not bother the patient in any way and does not cause any painful sensations. Complications develop only if a bacterial infection is added to the lesion.

After a few days, the redness turns into a flat papule, and after some time into an erosion or ulcer with a compacted base. A hard chancre has a bottom that is located at the same level with the skin or slightly raised above.

In almost 90% of cases in women and men, chancre looks like erosion. An ulcer is formed:

• when the body is weakened as a result of concomitant chronic diseases;
• as a result of intoxication;
• when self-medicating with local irritants;
• failure to comply with basic personal hygiene rules;
• in young or elderly patients.

When formed on the penis in men, the hard chancre is covered on top with a transparent, dense detachable film. It is in it that pale treponema is found, which is then used to determine syphilis. If a chancre is located on an open area of ​​the body, then on top it is covered with a dense brownish film.

The size of chancre can be:

• from 1 to 3 mm – dwarf, it is considered the most dangerous from an epidemiological point of view;
• from 1 to 2 cm – average;
• up to 4–5 cm – gigantic, localized on the skin of the thighs, pubis, forearms or face.

Hard chancre in humans can vary in the number of morphological units, that is, it can be single or multiple. If multiple chancres are present, they can appear all at once or sequentially, one after another, after some time. If there are multiple lesions on the skin, then chancre appears in several places at once, that is, where Treponema pallidum penetrates the body. Multiple chancre most often occurs during repeated sexual intercourse with a partner with syphilis.

Atypical chancroid

Rarely, men and women infected with syphilis have chancre in atypical form. These include:

• amygdalitis;
• indurative edema;
• chancre-pansirium.

Amygdalitis chancre is very different from the usual hard chancre on the tonsils. He has others external symptoms. In most cases, amygdalitis looks like a unilateral enlargement of the tonsil, which occurs very suddenly. It becomes dense to the touch and hyperemic. This symptom is sometimes confused with manifestations of tonsillitis.

Indurative edema occurs in the labia in women or the foreskin in men. The affected area, unlike a typical chancre, after some time increases in size two to three times, becomes dense to the touch and acquires a bluish tint. The swelling is not painful and is not accompanied by acute inflammatory symptoms.

Chancroid felon is the most atypical manifestation; its danger lies in the fact that the symptoms completely coincide with ordinary felon, and it looks exactly the same. This may lead to an incorrect diagnosis. Chancre-felon is characterized by localization on distal phalanx big or index finger. A bluish-red swelling appears on the affected area, which turns into an ulcer with a purulent coating at the bottom and uneven deep edges. Chancre-felon is characterized by symptoms such as throbbing or shooting pains. Most often, it occurs in gynecologists and operating surgeons who are in direct contact with the body of a person infected with syphilis, thus chancre-felon in most cases is the result of occupational infection.

Syphilis in the form of chancre-felon is very rarely detected on time, and therefore the diagnosis becomes known already in the second stage of the disease. Timely detection of atypical chancre is very important, since the primary stage of syphilis is treated most effectively.

Treatment

Chancre in a person infected with syphilis is treated in a hospital or outpatient setting. Throughout the course of therapy, cessation of any sexual contact is required. It is necessary to treat all sexual partners of a person with syphilis, regardless of how many there were. The fact is that the probability of their infection with Treponema pallidum is extremely high.

Treatment of chancre is carried out with antibacterial medicines penicillin group, since the causative agent of syphilis has not lost sensitivity to them. Most often this injection forms ampicillin and benzylpenicillin.

You need to know that chancre in itself is not dangerous. It allows you to detect syphilis at its earliest stage. And therefore timely treatment makes it possible to prevent further development diseases and complications. If you find a formation on the skin that resembles the description of a chancre, you should immediately consult a doctor for examination.

After suspicious unprotected sexual intercourse, it may be prescribed preventive treatment, which will prevent the penetration of the syphilis pathogen into the body. To do this, you should immediately contact a dermatovenerologist.

Hard chancre (primary syphiloma, hard ulcer) is a morphological element on the skin or mucous membranes, which is formed at the stage of primary syphilis - a chronic infectious disease, predominantly sexually transmitted, the causative agent of which is Treponema pallidum ( Treponema pallidum). The localization of hard chancre depends on the place of introduction of the pathogen into the body. Education can be either single or multiple.

A chancre is a dense, painless ulceration that appears between 10 days and 3 months from the time of infection. Upon admission antibacterial drugs The incubation period of syphilis may be prolonged. With simultaneous infection from several sources, the incubation period is reduced.

Causes

Infection occurs through contact and household (most often sexual) means. In addition, transmission of an infectious agent can occur during surgical intervention, childbirth, during blood transfusions, breastfeeding. Treponema pallidum infection can occur through dental or other medical instruments, bed linen, personal funds hygiene of a sick person, dishes. A possible route of transmission of syphilis from mother to fetus is through the placenta (transplacental route of transmission).

Child with congenital syphilis dies shortly after birth or has severe lesions internal organs.

Types of chancre

Chancre is classified according to several criteria.

Depending on the size of the ulceration:

• dwarf chancre (up to 10 mm);
• medium-sized chancre (10–25 mm);
• gigantic (up to 55 mm).

The most contagious is dwarf chancroid. Giant hard chancres are localized mainly on the abdomen, thighs, pubis, forearms, etc. (in places where subcutaneous tissue is abundant).

Based on the number of ulcerations, there are:

• single;
• multiple chancres.

Multiple hard chancres are rare; they occur when repeated infections during the first few weeks and/or with the simultaneous introduction of an infectious agent in several places.

Depending on location:

• genital chancroid (on the genitals);
• extragenital (in the mouth, on the face, mammary glands, legs, near the anus, on the scalp, etc.);
• bipolar (located simultaneously on the genitals and other parts of the body).

Considering the fact that infection in most cases occurs during sexual intercourse, the localization of chancre is predominantly genital.

According to the form of education there are:

• typical;
• atypical (atypical) chancroid.

Chankry atypical shape, in turn, are divided into:

• chancre amygdalitis (anginal) – localized in the tonsil area, most often the lesion is unilateral. The mucous membrane above the tonsil changes color, the tonsil increases in size, is compacted and painless on palpation. Voice changes may be observed (hoarseness, hoarseness);
• chancre felon - formed on the fingers (most often on the terminal phalanges of the index and thumb), characterized severe pain shooting character. Swelling occurs at the site of the lesion. The ulceration has uneven edges with suppuration inside the morphological element from which it comes bad smell. The pathology is typical for surgeons and gynecologists who perform invasive interventions, as well as for other medical workers in the event of injury from contaminated medical instruments;
• indurative edema - localized mainly on the genitals. Requires differential diagnosis with pathological conditions with similar clinical manifestations. It differs from edema of other origins in that when pressed it does not leave dents.

Atypical hard chancre is characteristic of cases of combination of syphilis with other infectious diseases.

In addition, among hard chancres there are:

• slit-shaped - localized in the interdigital spaces, corners of the mouth and folds of the skin;
• diphtheria - ulceration covered with a necrotic gray crust;
• herpetiformes – clinical manifestations similar to genital herpes;
• Folman's balanitis - characterized by multiple small erosions and a clearly defined edge.

Symptoms of chancre

Hard chancre occurs at the site of introduction of the pathogen at the end of the incubation period of syphilis, which is often accompanied by increased body temperature, muscle and joint pain, enlarged regional lymph nodes and other symptoms.

Ulceration in primary syphilis usually takes the form of a round or oval erosion with clear boundaries and a saucer-like shape. The exudate gives the morphological element a varnished appearance. At the base of the ulceration there is a hard infiltrate; with deep damage, the infiltrate has a cartilaginous structure.

Against the background of weakened immunity and alcohol addiction, complications of chancroid such as gangrenization and phagedenism can occur.

Chancre is painless, heals even without treatment after 1.5-2 months, and ulcerative chancre scars, and erosive chancre heals without leaving any traces. The spontaneous disappearance of chancre does not mean a cure for the infection, but indicates the transition of syphilis to the secondary stage, which is more severe and dangerous. The healing time of chancre is determined by the nature of the infiltrate and its severity at the base. Giant hard chancres with a powerful infiltrate at the base can persist even at the stage of secondary syphilis.

In women, hard chancre of genital localization can form on the labia majora and minora, the clitoris, in the vestibule of the vagina, in the vagina, etc. In addition, hard chancre in women is often located on internal organs genitourinary tract(for example, on the cervix). In this case, the symptoms of chancroid may go unnoticed, and this may cause further infection of sexual partners and other contacts. Typical chancre is not characterized by inflammation. With indurative edema, the labia majora and minora become enlarged, sometimes acquiring a cyanotic tint.

Chancre in men is often localized on the body and head of the penis, the surface of the foreskin, and the urethra. When located on the urethra, the chancre is painful on palpation, interferes with urination, and bleeds. In some cases, cicatricial narrowing of the urethra is observed. If the outflow of lymph is impaired (if there is damage to lymphatic vessels) indurative swelling forms on the penis or scrotum.

With the extragenital location of chancre, it is most often localized in the mouth. The edges of the chancre are dense and red. On the lips, including in the corners of the mouth, chancre becomes crusty yellowish color. Hard chancre in the pharynx, tonsils, hard and soft palate, and gums develops less frequently.

When you press on the chancre from the sides, a yellowish liquid appears on its surface. This symptom has the name “crying chancre” and serves for the differential diagnosis of syphilis from other pathologies.

The clinical picture of chancre may change when a secondary infection is added.

Diagnostics

Diagnosis of syphilis is based on the detection of pale treponema in chancre discharge, the results of a serological blood test and, if necessary, additional research data.

Infection with Treponema pallidum can occur through dental or other medical instruments, bedding, personal hygiene products of a sick person, and dishes.

Required differential diagnosis with soft chancre. Solid and chancroid(chancroid) have a number of similar symptoms, but soft chancre is painful, has soft edges, and also forms purulent-hemorrhagic exudate.

Treatment of chancroid

The purpose of the therapy is to eliminate the infectious agent (treponema pallidum), restore affected tissues, increase immunity, and prevent relapses and/or complications. Treatment can be carried out both on an outpatient basis and in a hospital setting. When syphilis is determined in one of the sexual partners, diagnosis and preventive treatment are indicated for the second (other) sexual partner and contact persons. You should avoid sexual contact with an infected person until he or she has completely recovered.

Treatment regimens for chancroid (i.e. primary syphilis) vary depending on the severity of the course, the location of the ulceration and a number of other reasons. Main drugs drug therapy are antibacterial agents. They are selected individually, taking into account the probable co-infection, sensitivity of microorganisms and drug tolerance. Therapy is carried out under the control of tests. Sulfonamides have proven themselves to be effective in the treatment of syphilis. Antibacterial drugs are supplemented restoratives, as well as immunomodulators. In the presence of allergic reaction antihistamines are indicated.

Besides general treatment, treat chancroid with drugs for external use that have anti-inflammatory, disinfectant effect. If chancre is located in the mouth, rinsing the mouth with solutions of antibacterial drugs is prescribed. local action. Maintaining hygiene in the chancre area is of no small importance.

Therapy for syphilis at the primary stage of the disease (chancroid stage) ends complete cure. Advanced disease requires long-term therapy (up to several years), and dispensary observation behind the dynamics of convalescence.

Prevention

Measures to prevent syphilis include:

• protected sexual intercourse;
• refusal of casual sexual relationships;
• avoiding the use of other people's personal hygiene products, dishes, etc.;
• regular examination of persons belonging to risk groups (persons leading an antisocial lifestyle, suffering from alcohol, drug addiction, medical workers and etc.);
• drug prevention for casual unprotected sexual intercourse.

Consequences and complications of chancroid

With progression of the disease and absence necessary treatment infectious process spreads to other organs and tissues of the body.

When a secondary infection occurs, men develop inflammation of the glans penis (balanitis) and the inner surface of the foreskin (posthitis), which in some cases becomes the cause of a complication of chancre such as narrowing of the foreskin, or phimosis. The latter is often complicated by pinching of the glans penis by the foreskin (paraphimosis).

The addition of a bacterial or trichomonas infection to chancroid in men leads to acute inflammation around ulcerations and narrowing of the foreskin.

In addition, against the background of weakened immunity and alcohol addiction, complications of chancroid such as gangrenization and phagedenism may occur.

In pregnant women, syphilis can cause transplacental infection of the fetus with subsequent death during the period of prenatal development. A child with congenital syphilis dies soon after birth or has severe damage to internal organs.

Video from YouTube on the topic of the article:

Chancre is the primary stage of syphilis. Syphilis belongs to a number of infectious diseases and has 3 stages. Its causative agent is Treponema pallidum. Chancroid is also known as primary syphiloma, and it occurs at the site through which the pathogen entered the body.

• What does chancre look like?
• Atypical form of the disease
• Basic aspects of therapy

How chancroid develops

Hard chancre, or primary syphilis, forms 3-4 weeks after penetration of Treponema pallidum. The causes of infection are usually the same - sexual contact with an infected person, use of common hygiene products. Chancroid is the most benign form of syphilitic infection because:

• its localization is limited (most often found on the penis or in the oral cavity);
• the active form is characterized by sparseness and monomorphism;
• the formation does not affect internal organs;
• effective and relatively easy to treat.

Most often, signs of chancroid appear in the genital area. However, in 10% of cases, hard chancre can appear on the mucous membrane of the mouth, on the tongue, on the lip, on the chest in women, on the tonsils.

What does chancre look like?

Hard chancre begins with a red spot with smooth edges (what primary syphilis looks like can be seen in photos 1, 2). The spot diameter is no more than 15 mm. The spot has a regular round or oval shape. It does not cause any discomfort to the patient, does not itch or burn. However, in case of joining bacterial infection complications may arise. The latter is evidenced by the uneven edges of the formation, painful sensations when touched.

Photo 1 and photo 2. Localization of chancre in the genital area.

After a few days, the spot becomes a flat papule, and a little later it turns into a state of erosion or ulcer (less often) with a compacted base. The bottom of the ulcer is level with the skin around it or rises slightly above it.

In the vast majority of cases, chancre takes the form of erosion. Ulcer formation occurs due to:

• the patient has other chronic infections;
• intoxication of the body;
• therapy using topical irritants;
• neglect of personal hygiene measures;
• teenage or elderly patient.

There are 3 types of chancre depending on the size of the formation:

1. Dwarf - 1-3 mm.
2. Average - 10-20 mm.
3. Giant - 40-50 mm. Typically appears on the thighs, pubic area, face and forearms.

In addition, chancre is classified according to the number of formations on the patient’s body:

1. Single type.
2. Multiple type. IN in this case chancre is formed simultaneously or sequentially in several locations through which treponema pallidum entered the body.

In addition to the hard form of chancre, soft chancre is also isolated. It differs somewhat in morphology from solid. Hard and soft chancroid are symptoms of a syphilitic infection.

Atypical form of the disease

IN in rare cases People who become infected with syphilis from a sick person may develop chancroid of an atypical nature. These include:

• indurative edema;
• amygdalitis;
• chancre-pansirium.

Indurative edema is localized in the area of ​​the foreskin (in men) or the labia (in women). Over time, the affected area increases in size by 2-3 times, becomes dense and cyanotic. In this case, the swelling does not cause pain.

As mentioned above, sometimes symptoms of the disease can appear on the tonsils. However, amygdalitis is different from regular form chancre. There is a sharp increase in size of the tonsil, and on one side. The body of the tonsil becomes dense and inflamed. This phenomenon can be mistakenly taken for one of the symptoms of a sore throat.

The symptoms of chancre-felon are almost identical to those of ordinary felon. This complicates the diagnosis of chancre. Chancre felon appears on the phalanges of the fingers. The lesion is characterized by bluish-red swelling with further formation of an ulcer with the formation of pus. With this type of primary syphilis, the infected person feels throbbing or shooting pain in the affected area.

Basic aspects of therapy

If a person is diagnosed with chancroid, he is prescribed treatment in a hospital or on an outpatient basis. Since the main and most common method of transmission of infection is sexual, any sexual contacts the patient should stop during treatment. In addition, all previous and current sexual partners of the patient should undergo examination and, if necessary, therapy, even if they do not have any symptoms.

Primary syphilis is treated with antibiotics of the penicillin group, since Treponema pallidum is sensitive to them. Often injections of benzylpenicillin and ampicillin are performed.

Chancre is an early stage of syphilitic infection.

By starting treatment at this stage, the infected person will recover easily and quickly, preventing the infection from progressing and eliminating the possibility of complications.

As soon as formations similar in morphology to chancre are found on the body in characteristic locations, a person should immediately seek advice from a dermatovenerologist.

If a person has had sexual intercourse with a suspected carrier of the causative agent of syphilis, he should also contact a specialist for treatment. preventive measures to avoid infection.

Become scourges modern society. Is it possible to identify them early stage? Yes, if, for example, we are talking about syphilitic chancre. What it is?

This article will examine in detail the question of how syphilitic chancre is smoothed out and what are its features. You can also find out how to treat this infection. And, of course, photos of syphilitic chancre and its manifestations will be given.

How it appears

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

What it is

From what is written above it becomes clear that syphilitic chancre is initial stage syphilis. Externally, 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, do not 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 chancre can go away on its own, without treatment. However, this does not mean that the disease went away on its own. The disappearance of chancre indicates that syphilis has passed into a deeper form or has found a new place to localize the infection.

A little about the main disease

Since syphilitic chancre is the initial stage of such venereal disease, like syphilis, you should learn more about it.

Syphilis is a sexually transmitted infectious disease caused by the entry into the body 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, treponemes die instantly, and at +60 °C they can self-destruct after fifteen minutes.

How can you become infected with 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 due to the use of the same household items (towels, bed linen, toothbrush, dishes that were not exposed to special treatment medical instruments). In such cases, syphilitic chancre may appear on the arms, neck, and shoulders of the infected person.

In addition, syphilis can be contracted through blood transfusion.

How do doctors classify skin manifestations diseases?

Types of anomalies

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

Skin manifestations of the disease can be isolated or localized in groups.

According to the depth of damage to the epidermis, the following chancres are distinguished:

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

Based on the size of the wounds, experts distinguish the following categories of syphilitic chancre:

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

Where it all begins

How to determine that an infected person has an unusual skin rash or an ulcer, or 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 ​​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 chancre is oval or round, with smooth, dense edges.
• The bottom is dark red in color and has a firm density.
• Sometimes the outer surface of the chancre has a purulent yellowish coating.
• The skin around the tumor is most often not inflamed, does not change color or thicken.
• If you press on the chancre from both sides, it will come to the surface. clear liquid light yellow color. Be careful: it contains treponemes.

Progression of symptoms

The chancre may remain on the skin for several weeks and then completely disappear or heal. This means that syphilis has taken a latent form.

After this, the patient will begin to be bothered by other symptoms indicating a deterioration in general health:

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

This is due to the fact that treponemes are actively developing and spreading throughout the body.

Atypical (atypical) skin manifestations

Syphilitic chancre does not always have the characteristics described above. In some cases, syphilis can be complicated by other infectious diseases such as gonorrhea, genital herpes, and chlamydia. Then the chancres can change. The most common manifestations of syphilis on the patient’s body are:

• Felon. It occurs on the hands, most often on the fingers of the infected person. Mainly - occupational diseases, affecting gynecologists or surgeons due to careless actions or other reasons. Such neoplasms cause a lot of pain and can provoke swelling of the dermis around the wound, suppuration, and a feverish state of the patient.

• Amygdalite. In other words - syphilitic chancre in the mouth. Affects one or two tonsils. Rarely bothers a person in the form painful symptoms. Most often it manifests itself in an enlargement of one tonsil; the condition is not accompanied by an increase in body temperature or pain in the lymph nodes.
• Indurative edema. Appears on the genitals of an infected person. As a result, there arise painful sensations caused by enlargement of the genital organs.
• Syphiloma-herpes. Most often, such syphilitic chancre in men manifests itself in inflammation of the head of the penis and the inner foreskin. This disease is also accompanied by the fact that foreskin, moved away from the head, does not return back. It is even possible that the head may be pinched by the pericutaneous ring.

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

Appearance on genitals

Localization of syphilitic chancre 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 initial stage of syphilitic chancre appears on the posterior commissure of the labia or cervix.

These tumors do not always look scary. The fact is that they may be no different from ordinary erosion or minor damage. At the same time, such chancres can hurt and bleed.

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

Sometimes areas may be affected skin located in close proximity to the genital organs - pubis, abdomen or thighs.

Non-genital localization of syphiloma

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

Most often, chancre is observed on the lips, mucous membranes, tip of the tongue, and 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 if skin neoplasms similar to syphiloma appear, you must immediately contact a specialist to prescribe urgent and comprehensive treatment.

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

How to detect syphilis? To do this you will need to submit necessary tests blood, and also submit a smear of chancre for examination.

How is the treatment carried out?

You should also know that both partners will need to undergo 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 regular partners, then preventive treatment should be carried out on everyone with whom he came into intimate contact three months before the onset of chancre. Sometimes drug therapy may be needed for partners with whom there has been intimacy for six months or even more.

Also, during the treatment period, you should adhere to sanitary and hygienic standards as strictly as possible. This refers to regularly and carefully treating household items, personal hygiene items, 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 chancre are the mouth, fingers, and the like.

Drug therapy

What does treatment for syphilis include? First of all, this is antibacterial 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 antibiotics such as penicillin, tetracycline, cephalosporin and their derivatives. Thus, the most commonly prescribed drugs are:

• “Estencillin.” Usually used in the form intramuscular injections. The product is used twice, together with 0.5 percent novocaine. Sometimes one injection is enough.
• “Bicillin-5”. It is also administered intramuscularly, twice (the period between injections is five days).
• "Erythromycin". A tablet taken at a dose of 500 mg four times a day, half an hour before meals or an hour and a half after.
• “Doxycycline.” Also a tablet drug, taken four times a day, five hundred milligrams during or immediately before meals.

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

If syphilitic chancre is found in the oral cavity, then in this case the attending physician may prescribe rinsing the mouth with furatsilin (diluted with water in a ratio of 1:10,000), boric acid(two percent solution) or gramicidin (also a 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 about immunity

Since syphilis significantly reduces the body’s protective function, important part Therapy for such a disease is to increase the patient’s immunity. This can be done using traditional methods, and pharmacological drugs.

For example, immunostimulating drugs may be prescribed, as well as vitamins and a complex useful microelements that help improve immunity.

Other treatment factors

An important factor in successful drug therapy is compliance the right image life during treatment. 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 to patients with syphilis. Its essence lies in the use large quantity proteins and minimizing the consumption of fats, especially animals.

Moreover, during the treatment period it is very important to monitor psycho-emotional state patient. A patient with syphilis should not overexert himself either mentally or physically. It is recommended to avoid all kinds of stress, worries, and stress. To do this, it is recommended, if necessary, to use medications prescribed by a doctor.

We looked at what syphilitic chancre looks like and how to treat it.