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Syphilis is divided into congenital syphilis
and syphilis akuisita (acquired). Syphilis
akuisita divided clinically and
epidemiologically.
Clinically, divided into three stages, namely
stage I (SI), stage II (SII), and stage III (SIII).
In epidemiological according to the WHO,
syphilis stage I and II are included in the
early stage are infectious.
Pathogenesis
The incidence of syphilis in various
countries around the world in 1996
ranged between 0.04 -0.52%. The
incidence is lowest in China, while
the highest in South America. In
Indonesia, the incidence of 0.61%
cont
In 60%70% of cases of primary
syphilis,
painless
regional
lymphadenopathy arises 710 days
after the chancre appears, especially
when the chancres location is
genital.
Katz KA. Syphilis. In: Goldsmith LA, Katz S, Gilchrest BA. 2008.
Fitzpatricks Deramatology in General Medicine. 8 th Edition. New York:
McGraw Hill. p 2472-2492
cont
Syphiloderm (3-12 weeks after the
chancres appears)
Erythematous
macules
(roseola
syphilitica) or maculopapules are
commonly present symmetrically on
the trunk and extremities in 40%70%
of
cases
with
papular,
papulosquamous, or lichenoid
Lesions are not usually pruritic
Papulosquamous
syphilitic eruption
with erythematous,
well-demarcated,
flattened plaques
covered with scales
(Biettes collarette).
cont
Erythematous to copper-colored round
papules, well demarcated and sometimes
with an annular scale, are present on the
palms and soles in nearly 75% of cases.
Other
dermatologic
manifestations
include a patchy nonscarring alopecia,
described as moth-eaten or, less
commonly, a diffuse alopecia of the
scalp.
Additional Examination
1. Direct Detection of Treponema
pallidum
It appears as a pale, white,
Darkfield microscopy
2. Serological Test
Nontreponemal Serologic Test
. Veneral Disease Research
Laboratory test (VDRL)
. Rapid Plasma Reagin test (RPR)
Katz KA. Syphilis. In: Goldsmith LA, Katz S, Gilchrest BA. 2008.
Fitzpatricks Deramatology in General Medicine. 8 th Edition. New York:
McGraw Hill. p 2472-2492
Primary Syphilis
Herpes simpleks
Chancroid
Early sharply
circumscribed ulcer in
the coronal sulcus
Katz KA. Syphilis. In: Goldsmith LA, Katz S, Gilchrest BA. 2008.
Fitzpatricks Deramatology in General Medicine. 8 th Edition. New York:
McGraw Hill. p 2472-2492
Granuloma inguinale
Katz KA. Syphilis. In: Goldsmith LA, Katz S, Gilchrest BA. 2008.
Fitzpatricks Deramatology in General Medicine. 8 th Edition. New York:
McGraw Hill. p 2472-2492
Lymphogranuloma venerum
Katz KA. Syphilis. In: Goldsmith LA, Katz S, Gilchrest BA. 2008.
Fitzpatricks Deramatology in General Medicine. 8 th Edition. New York:
McGraw Hill. p 2472-2492
Secondary Syphilis
Pityriasis rosea
Katz KA. Syphilis. In: Goldsmith LA, Katz S, Gilchrest BA. 2008.
Fitzpatricks Deramatology in General Medicine. 8 th Edition. New York:
Condyloma akuminata
Multiple confluent
condylomata on the labia
majora and minora
Multiple condylomata
acuminata on the shaft of the
penis
Katz KA. Syphilis. In: Goldsmith LA, Katz S, Gilchrest BA. 2008.
Fitzpatricks Deramatology in General Medicine. 8 th Edition. New York:
Drug eruption
Psoriasis
Treatment
CDC Recommendations for Treatment and Follow-up of Adults with Primary, Secondary, or
Early Latent Syphilis
Complication of treatment
The JarischHerxheimer reaction is a selflimited clinical syndrome consisting of fever,
headache, flare of mucocutaneous lesions,
tender
lymphadenopathy,
pharyngitis,
malaise, myalgias, and leukocytosis. It
occurs within 12 hours of initiating therapy
and resolves within 2436 hours. The fever
peaks 68 hours after the onset, usually
around 39C , but it can be as high as 42C
Katz KA. Syphilis. In: Goldsmith LA, Katz S, Gilchrest BA. 2008.
Fitzpatricks Deramatology in General Medicine. 8 th Edition. New York:
Cont ..
Acetaminophen can be used to attempt to
diminish the reaction, although very little
evidence of its effectiveness exists.
Anaphylaxis form reaction managed by
intramuscular injection of epinephrine and
diphenhydramine with hydrocortisone
intravenously
Katz KA. Syphilis. In: Goldsmith LA, Katz S, Gilchrest BA. 2008.
Fitzpatricks Deramatology in General Medicine. 8 th Edition. New York: