DefinitionThis section has been translated automatically.
LocalizationThis section has been translated automatically.
Predilection site is the genital region.
- In men, the inner preputile leaf, sulcus coronarius, more rarely the penis shaft or penis root
- In women, small and large labia, posterior commissure, perineum.
Extragenital: labial mucosa, tongue, palate, pharynx, rectum, perianal region
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Clinical featuresThis section has been translated automatically.
Early syphilis (Syphilis I):
- Syphilis I: incubation period 3-4 weeks.
- Primary effect: painless, mostly solitary (see also imprint chancre), indurated papules of different sizes, which ulcerates very quickly and changes into a painless, different sized, coarse ulcer ( ulcus durum). In about 5% of cases the primary effect also occurs extragenitally (mainly orally; rarely on fingers or mammilla).
- The ulcer is accompanied by a regional, less painful lymphadenopathy of the groin region (primary complex), which occurs about 1-2 weeks after the onset of the ulcer.
- Special form: Oedema indurativum. Primary complex = indolent regional lymphadenitis (bubo) + primary effect.
- Syphilis II: After about 2-3 weeks spontaneous remission of the primary complex. The patients are free of symptoms during the first latency phase of 4-6 weeks. The stage of generalized spirochetosis begins about 7-8 weeks after infection. There are general clinical symptoms such as fatigue, exhaustion, slight fever, sore throat, generalized lymphadenopathy (indolent, shifting, an important sign from a differential diagnostic point of view [DD: lymphatic systemic diseases!]), muscle and joint pain.
DiagnosisThis section has been translated automatically.
- Native detection of spirochetes from irritant secretion using the darkfield method (this method is now only used by a few people and is therefore no longer relevant in practice).
- Syphilisserology: detection of IgM antibodies (IgM FTA-Abs test) is possible 2-3 weeks after infection (i.e. ready in an early phase of ulcer formation)
Differential diagnosisThis section has been translated automatically.
Herpes genitalis, Ulcus molle, Aphthae nbei M. Behçet; Erythroplasia Queyrat, Balanitis plasmacellularis
TherapyThis section has been translated automatically.
Benzathine penicillin G 2.4 million IU 1x i.m. Alternatively: Ceftriaxone 1.0 daily i.v. over 10 days. Doxycycline 100mg 2x/day p.o. over 14 days
LiteratureThis section has been translated automatically.
- Adam B (2001) The punishment of Venus. A cultural history of venereal diseases. Orbis, Munich
- Nenoff P et al (2017) Nonviral sexually transmitted infections-epidemiology, clinical manifestations,
diagnostic workup, therapy: Part 3: Treponemes, Gardnerella and trichomonads. Dermatologist 68:136-148.
Outgoing links (6)Impact chancre; Obligation to notify; Oedema indurativum; Primary effect; Ulcer durum; Venereal diseases;
Please ask your physician for a reliable diagnosis. This website is only meant as a reference.