| ( Ⅰ ) primary syphilis: Chancre appears mostly in genitals such as coronary sulcus, penis, and foreskin for male individuals and labia minora and abium majus pudenda, or cervices for female individuals 2-4 weeks after infection. It looks like a papilla in the beginning, and swiftly become a reddish small ulcers round shaped about 1 -2 cm in diameter, with a little serosity attached on and a large amount of treponema pallidum inside. The chancre occurs singly, with cartilage like mass, and without any pain, which will naturally disappear within 3-8 weeks even if treatment is not received, without local trace or only with slight atrophic scar. Besides, the inguinal lymph nodes may swell to be hard mass, without reddishness, pain, fever, and pyogenesis, with treponema pallidum inside.
( Ⅱ ) secondary syphilis
As the treponema pallidum enters into blood circulation and then spread resulting in systemic symptoms, 7-10 weeks after infection, it may appears low fever, headache, myalgia arthralgia, and enlargement of lymph nodes of the whole body.
The whole body may appears skin rash, manifesting as macula, papula, pustule, oyster shell like eruption and so on, copper red in color, with a few squama attached which usually distribute symmetrically and densely but not confluently. There is no subjective symptom, and there is diagnostic significance if these syphilids occur on palms or metatarsus.
With the gradual formation of antibodies inside body, the immunity intensifies, therefore, syphilid may naturally disappear, but also may reoccur, which is known as secondary syphilid, however, the reoccurring syphilid is small in distribution and few in number.
Damage of mucous membrane: it manifests as reddening and swelling or even erosion of mucosa with exudates, another case if the flat papula around external genital organs, usually also known as flat condyloma because of easy erosion and effusion on the surface resulting form frequent friction, with a large amount of treponema pallidum inside resulting in strong infectivity.
( Ⅲ ) tertiary syphilis: It invades not only the skin and mucous membrane, but also involves in internal organs and tissues all around the body, with large destructive, however, it is less infectious because the treponema pallidum has not been found in large amount.
Ⅱ congenital syphilis: Treponema pallidum enters into fetus through umbilical cord blood under the filtering and dispersion by maternal placental villus. As the placental circulation is not complete during the first four months of the pregnancy, and immunologic function of fetus is also not mature without any reaction to infections, therefore, the congenital generally occur after the first four months of the pregnancy. The infection of syphilis of pregnant women may lead to abortion, premature delivery or dead fetus. |
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