by Carlo Raj, MD

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    Syphilis. A few words about syphilis when dealing with dermatology. Infectious. Treponema pallidum. Diagnosis by RPR and the stages is where I want to spend a minute. If it’s a primary chancre, remember that a chancre is painless. A chancre is a painless ulcer in either the oral or genital region as opposed to or compared to chancroid. A chancroid, ouch, it hurts so much so that I will be crying, referring to Haemophilus ducreyi. So Haemophilus ducreyi will be chancroid, D and D. And you’re crying because it hurts. Chancre is painless and this also might be located in the genital regions or maybe perhaps around the oral regions. The secondary: The rash should be on the palms and soles, may or may not be on the trunk. And tertiary, may involve the bone and some of the soft tissue and this then referred to as being your necrotic type of ? Good. Granulomas. And you have your CNS. Gumma is what we’re talking about for tertiary. Remember please, secondary: Rash on the palms and the soles, don’t forget those for secondary. For syphilis, we’re showing you penis in which you’d find your ulcer, in which in this patient, was not expressing pain because a chancre is painless. Guess what you’re going to find? You’re going to find these spirochetes on dark field microscopy and positive for RPR. Two to three weeks after exposure. Occurs weeks to month after infection. The palms and soles would be the targets if you’re referring to secondary type of syphilis and if you have alopecia, it will be like a moth-eaten alopecia and condyloma lata. Remember lata is syphilis. “I want a lata syphilis.” I'm just joking, but condyloma lata would be the infection on the skin that you would be looking for...

    About the Lecture

    The lecture Syphilis by Carlo Raj, MD is from the course Infectious Skin Diseases.

    Included Quiz Questions

    1. Dark field microscopy
    2. ELISA
    3. Skin biopsy
    4. Wood lamp test
    5. Light microscope
    1. Granulomatous ulcer
    2. Painless ulcer
    3. Diffuse rash involving the hands and soles
    4. Painful ulcer
    5. Moth eaten alopecia
    1. Reassure the patient and recommend continuing penicillin
    2. Switch to oral penicillin
    3. Completely stop taking penicillin
    4. Mention this is an adverse drug reaction and he should never take penicillin again
    5. Hold penicillin until symptoms resolve and continue again

    Author of lecture Syphilis

     Carlo Raj, MD

    Carlo Raj, MD

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