late syphilis Flashcards
defined as
CDC: infection of more than 1 yr in duration
WHO: more than 2 years.
only 1/3 of pxs w late syphilis will develop complications of their infection. thank
demonsrated by immunoperoxidase techniques.
tertiary cutaneous sy
most often occur 3-5 yrs after infectionz
16% of untreated pxs will dev tertiary lesions of the skin. mucous membrane. bone or joints.
skin lesion localized to occur in grps destructive and heal with scarring.
2 main types of cutaneous tertiary sy
nodular sy
gumma.
nodular/ or tubercular type- firm reddish brown or copper colored papules or nodules 2mm in diameter or larger.
kidney shaped lesion on extensor arms and back.
unilateral isolated single or disseminated lesions or serpiginous patterns resembling nodular syphilid.
may be restricted to skin originating in deeper tissues, breakinh down and sec oncolve the skin. individual lesions wx begin as small nodules slowly enlrage to sev cm. centrral necorisis is extensive lead to the dormation of a deep punches out ulcer and steep sides and gelatinous necrotic base.
progressuon may take place in one arra while healing proceeds in another.
Gumma.
most freq site of isolated gumma- lower legs, where deep punched oit ulcers are formed.
tertiary sy of tongue may lead to
diffuse enlargement (macroglossia)
perforation of hard palate w gummatoud inv is char tertiary manifestation.
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tuberculoid granulomas cont varying numbers of multinucleate giant cells.
epidermis atrophic rather than hyperplastic.
in gummas, necrosis within granulomas and fibrosis occur as lesions resolve. spirochetes are scant.
late osseous sy
most kften affexts head and face and tibia.
late manif of sy: periostitis, osteomyelitis, osteitis, gummatous osteoarthritis.
osteocope(bone pain) most often at night is a suggestive sx.
syphilitic joint lesions occur w charchot joint being the most prevaler manif.
