Clinical
Manifestations
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- This is a systemic disease and can affect any tissue or vascular organ of the body.
- It has a protracted course.
- Primary Stage:
Chancre which appears within four weeks of infection and heals within for to eight weeks without treatment.
Primary chancres appear on:
Men:
Penis
Anus
Rectum
Women:
Vulva
Cervix
Perineum
Both:
Lips
Tongue
Buccal mucosa
Tonsils
Fingers
A red papule appears and quickly erodes into a painless ulcer with a lacquer-like base and hard walls.
It does not bleed.
When scratched, it exudes a clear serum.
A red areola may surround the lesion.
- Secondary Stage:
Skin rashes usually appear within 6-12 weeks.
Skin rashes are most prominent after 3-4 months.
The rashes may be transitory or may persist for months.
The primary chancre may disappear.
The rashes are symmetrical and are more marked on the flexor surfaces, particularly the palms of the hands and soles of the feet.
Over time the number of lesions decreases and the symmetry becomes less obvious.
The individual spots are pigmented in dark-skinned people and are pinkish in light-skinned people.
The lesions do not itch and usually heal without leaving scars.
Most people have mucotaneous lesions and enlarged lymph nodes.
Some people have lesions affecting other tissues and organs including:
Eyes
Bones
Joints
Kidneys
Liver
Spleen
Constitutional symptoms may also be present such as:
Persistent headache
Malaise
Anorexia
Nausea
Aching bones
Fever
Insomnia
Jaundice
Neck stiffness
Alopecia in patches
Lesions affecting the mucous membranes often become eroded forming grayish-white circular patches with a red areola which are usually found on the:
Mouth
Palate
Pharynx
Larynx
Penis
Vulva
Anal canal
Rectum
These lesions are usually flattened, hypertrophic, dull pink or gray, resemble horny warts and are extremely contagious.
- Latent Stage:
Begins about 1 year after infection.
Relapses may occur.
After the second year new lesions are rare.
This stage may last several years or for the remainder of the patient's life.
In untreated cases, about one-third of those infected develop Late-Stage or Tertiary syphilis which may show up after many years.
- Tertiary or Late-Stage:
Lesions develop between 3 and 10 years after infection.
The typical lesion is a rubbery,
chronic, localized inflammation characterized by centralized gray-white necrosis, surrounded by granulized tissue.
They increase slowly in size, heal gradually and leave scars.
They may affect an organ or tissue.
Often they occur in Submucosal tissue such as the:
Palate
Nasal septum
Pharynx
Larynx
They lead to tissue degeneration with perforation of the palate, or septum.
They occur in areas with good blood supply such as the:
Leg below the knee
Upper trunk
Face
Scalp
Eyes
Stomach
Lungs
Liver
Testicles
- Traditional Etiology:
Qi Affected:
The toxin primarily affects the Lungs and Spleen.
The lesions
are small.
The condition is less severe and rarely involves the internal organs or bones.
Jing Affected:
The lesions develop on the genitalia.
- The toxin affects the Kidneys, and Liver.
- The condition can be severe involving other organs, the bones and marrow.
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