SURGSEMINAR: Sexually Transmitted desease Syphylis Pathology

Tuesday, March 21, 2017

Pathology

Treponema can penetrate mucus membrane or skin and then through

the lymphatics and blood stream produce systemic infection.

The median incubation period is 21 days. Primary lesion appears

at the site of penetration and persists for 2 to 6 weeks.

* The histopathology of these lesions will show perivascular

infiltration by plasma cells and histiocytes. Capillary

endothelial proliferation eventually leades to obliteration of

small blood vessels.

* The chancre (primary lesion) will show treponema between

epithelial cells.

* Treponema will also be seen in the lymphatic channels and the

regional lymph nodes

* The manifestations of secondary syphilis appear six to twelve

weeks later and consists of dull red rash like skin lesions.

* Maculo-papular lesions appear later

* There is a generalised lymphadenopathy

* Treponema is found in many tissues including the spinal fluid

* Secondary lesions subside in 2-6 weeks

* The patient enters the latent stage

* This stage is detectable only by serological tests

* The World Health Organization defines latent stage more than

one year may continue for a life time.

* About one third of patients with untreated syphilis develop

clinically apparent tertiary diseases.

* In the past, tertiary disease was associated with Gumma; today

Gumma has become uncommon and the disorder caused by

obliterative small vessel endarteritis involving the

vesavasorum of the aorta and the central nervous system are

SURGSEMINAR