Why does chancre form and how to treat it. Chancroid in men and women photo initial stage of syphilis Ulcerative lesions of the tongue with syphilis

Description of the disease

Primary syphilis is the initial stage of syphilis, which develops after infection with Treponema pallidum. Primary syphilis begins with formations on the skin, as well as with penetration inside.

With primary syphilis, a hard chancre appears on the body. These formations can form both on the skin and on the mucous membranes.

Currently, modern medicine has identified some differences regarding the clinical picture of primary syphilis, compared with those manifestations that were noticed before.

For example, earlier at the initial stage of development of syphilis, a chancre was formed in a single amount in almost 90% of patients. Currently, chancre began to appear on the skin in the amount of two formations. In addition, the chancre began to increase in size.

In another article on our website, we discussed what kind of disease syphilism is.

Is it possible to prosecute a person who infects his sexual partner or other people around him with a sexually transmitted disease? It is possible if the disease is syphilis.

• Genital syphilis is transmitted sexually.
• Congenital syphilis is diagnosed when an infant is infected through the mother's placenta during pregnancy. Infection occurs at different stages of fetal development.
• Latent syphilis is a disease whose clinical manifestations are not detected. This form of syphilis can be detected after a thorough examination of the patient and various tests for syphilis.

The nose falls off with syphilis due to the destruction of bone tissue.

Ways of transmission of infection:

Chancre is the primary lesion on the skin with syphilis. It usually appears 18-21 days after infection; until this time the disease is not recognized and doctors talk about the incubation period.

Syphilitic chancre appears as a small reddish papule or slight superficial erosion. Over the course of a few days, the formation increases to several centimeters in diameter (2-3), and serous fluid oozes from the ulcer.

In women, the first genital chancre can be located in the vagina or on the cervix, in men on both sides of the frenulum. Extragenital chancre can be found on the lips, tongue, tonsils, chest, fingers and anus.

Chancroid is also similar to syphilis, but it is a completely different sexually transmitted disease, which is caused by Haemophilus ducreyi. It is usually detected in women and men 4 to 10 days after infection. The photo shows its signs, which include:

• Open wounds on the penis (as shown in the picture), around the opening of the vagina, in the rectal area, which are very painful.
• Presence of pus in ulcers.
• Soft edges of ulcers.
• Swollen glands in the groin.

Chancroid is sometimes also confused with herpes, so only a doctor, after research in the laboratory, makes an accurate diagnosis, excluding syphilis.

In the second stage of syphilis, ulcers appear in the mouth and throat area. On the tongue they may be ragged, with a hard base.

Around the same time, syphilitic roseola appears on the penis, chest, arms and forehead. They are painted dark red or copper.

They stay on the body for up to two weeks, although cases where they lasted up to 2-3 months are not excluded.

The third period of the disease is accompanied by syphilitic gummas. They form on the mucous membranes, skin, and subcutaneous tissues.

Gummas often affect muscles, internal organs, and bones. In the muscles they develop as tumors, on the surface as ulcers.

On internal organs they resemble fibroids, and on bones they resemble nodes. These formations are painful.

The pain is especially felt at night. Gummous syphilis even in the photo looks terrifying.

His most terrible act is the destruction of the brain and skull.

The statement that syphilis is exclusively a disease that is sexually transmitted is not entirely true. The fact is that you can become infected with it in everyday life when the infection directly enters the bloodstream through scratches or wounds on the body; this is also possible when using toilet items (towel, washcloth) belonging to the patient.

In addition, infection with syphilis can occur through blood transfusion, and syphilis can also be congenital. Basically, the rash is located in the areas of hair and steps, as well as on the palms.

In addition, in women it is also localized under the mammary glands; for both sexes, its concentration can be located in the genital area.

After 3-4 weeks from the moment of infection, the place where Treponema pallidum, the causative agent of infection of this disease (which is mainly the genitals), was introduced acquires signs indicating primary syphilis.

A sexually transmitted sexually transmitted disease, the symptoms of which are invisible in the early stages, is called syphilis.

This disease can affect:

• mucous membranes;
• internal organs;
• bones.

There is a hypothesis that syphilis spread through the slave trade and had its origins in Africa.

The answer to a similar question, what kind of disease is syphilism, can be found here.

Males do not attach importance to various rashes. Most often, they believe that this is either an allergy or signs of skin irritation. And at this time, the disease can become chronic, later developing serious complications.

Types of syphilitic roseola

As a rule, syphilitic chancre is divided into the following types, which differ in symptoms:

• A giant chancre most often forms in a place that is characterized by abundant fatty tissue under the skin. The size of such a chancre can reach the size of a child's palm.
• Dwarf chancre is distinguished by its size, which can reach the size of a poppy seed.
• Diphtheritic chancroid is distinguished by the fact that its surface is covered with a gray film, similar to diphtheria. This type is quite common.
• Cortical chancre forms in those areas of the body where discharge easily dries out (nose, lips, face).
• A slit-like chancre looks like a crack. Most often, this type forms in the corners of the mouth, between the fingers and in the anus.

After the infection has entered the human body, the incubation period of syphilis begins, which according to various sources lasts from several days to 6 weeks, but on average - three weeks.

During this period, a gradual growth of treponema pallidum cells is observed, which, however, is not accompanied by the appearance of any symptoms. This period is dangerous because a person, unaware of his illness, becomes a carrier and distributor of the disease.

There are the following types of roseola:

• fresh (appears for the first time), the most profuse rash of bright color;
• urticarial, or edematous (similar to urticaria);
• ring-shaped syphilitic roseola is characterized by spots in the form of rings or half-rings, arcs and garlands;
• with recurrent or confluent roseola, the size of the spots is usually much larger, and the color is more intense, but their number is smaller.

Very rarely, patients develop scaly roseola, covered with lamellar scales, and also similar to blisters, rising above the skin.

Erythematous syphilitic tonsillitis often develops on the mucous membranes. Confluent erythema of a dark red color, sometimes with a bluish tint, appears on the pharynx.

Their contours sharply border on healthy mucous membranes. The patient does not feel pain, he does not have a fever, and his general condition is practically unchanged.

In primary syphilis, 75% are chancre located in the oral cavity, on the face, and very rarely on the scalp. The remaining 25% are primary syphilomas of the upper extremities, anus, mammary glands, thighs and abdomen.

Bipolar chancre is the name given to primary syphilomas that appear simultaneously on the genitals and other parts of the body. They are rare.

Hard chancre of the oral cavity

Among the primary defects of extragenital localization, the most common are hard chancre on the lips, tonsils and tongue. Gums, pharynx, hard and soft palate - a rare localization.

Chancre is classified in different ways, usually based on one particular characteristic.

According to the depth of tissue damage, chancre is distinguished:

1. Erosive (more superficial);
2. Ulcerative (deeper).

According to the number of elements, chancre is classified into:

1. Single;
2. Multiple.

Rash in the second stage of syphilis

The primary chancre at the very beginning looks like a red spot, which over time turns into erosion.

The main signs of hard syphilitic chancre:

• The diameter of the spot on the skin or mucous membrane can reach 5 cm.
• The shape of the spot is oval.
• Education has clear boundaries.
• The color of the spot is red or burgundy.
• Presence of yellow purulent plaque.

From the video you will learn how syphilis is transmitted and how it manifests itself.

At the last stage of syphilis, destructive irreversible changes occur in the body. The pathogen affects all organs and systems of the body:

As we have already found out, the main manifestations of primary syphilis are chancroid, lymphangitis and lymphadenitis. How to distinguish them from other phenomena not related to syphilis? Let's look at these symptoms in more detail.

Chancre - features

In the photo, the chancre looks like a regular ulcer: it is round or oval in shape, bluish-red in color with a sore in the center. If the ulcer is not deep, it is called erosion. To the touch, a chancre is a hard formation; it feels like cartilage. The surface of the chancre is usually moist.

The location of the chancre can be:

• genital (labia, cervix, head of penis, scrotum, etc.);
• extragenital (oral cavity, lips, anus, fingers, breasts, etc.).

Develops in the absence of adequate treatment 6-10 or more years after infection. The main morphological elements of this stage are syphilitic gumma, syphilitic tubercle.

As a rule, at this stage, patients are concerned about severe aesthetic defects that form during the active course of syphilis.

Elements of the third stage of syphilis:

1. Tuberous syphilide is a dense tubercle of a cyanotic hue, which can necrotize according to the coagulation type, resulting in the formation of an area of ​​tissue atrophy. With liquefaction necrosis, an ulcerative defect is formed on the surface of the tubercle, in place of which, during the healing process, dense, receding scars are formed. Along the periphery of the resolving tubercles, new tubercles are formed that do not merge with each other.
2. Gummous syphilide is a node that forms in the subcutaneous fat. In the center of the node, a center of tissue melting is determined, a hole is formed on the surface of the skin, through which exudate is released from the center of the gum. The size of the presented hole gradually increases, as necrotic processes are activated, and a gummous core is formed in the center of the lesion. After its rejection, the ulcer regenerates with the formation of a deep retracted scar.

The photograph shows a star-shaped scar in the nasal area, which forms after the healing of an ulcer in the tertiary period of syphilis.

The manifestation of syphilis in women on the lips can take the form of large inflamed skin lesions, from which pus or blood often oozes. Such skin lesions can only be eliminated by surgery.

Signs of primary syphilis include the appearance of a small red spot that turns into a lump after a few days. The center of the tubercle is characterized by gradual necrosis of the tissue (its death), which ultimately forms a painless ulcer framed by hard edges, that is, chancre.

The duration of the primary period is about seven weeks, after the start of which, after about a week, all lymph nodes undergo enlargement.

The completion of the primary period is characterized by the formation of many pale treponemas, causing treponemal sepsis. The latter is characterized by weakness, general malaise, joint pain, fever and, in fact, the formation of a characteristic rash, which indicates the onset of the secondary period.

The secondary stage of syphilis is extremely diverse in its symptoms and it is for this reason that in the 19th century French syphilidologists called it the “great ape”, thereby indicating the similarity of the disease at this stage with other types of skin diseases.

Signs of the general type of secondary stage of syphilis include the following features of the rash:

• Absence of subjective sensations (pain, itching);
• Dark red color of the rash;
• Density;
• Clarity and regularity of roundness or roundness of outlines without their tendency to possibly merge;
• Peeling of the surface is of an unexpressed nature (in most cases its absence is noted);
• Spontaneous disappearance of formations is possible without subsequent atrophy and scarring.

Most often, rashes of the secondary stage of syphilis are characterized by the following manifestations (see photo of a syphilitic rash):

This stage of the disease is characterized by a small amount of Treponema pallidum in the body, but it is sensitized to their effects (that is, allergic).

This circumstance leads to the fact that even with the influence of a small amount of treponemes, the body responds with a peculiar form of anaphylactic reaction, which consists in the formation of tertiary syphilides (gummas and tubercles).

Their subsequent breakdown occurs in such a way that characteristic scars remain on the skin. The duration of this stage can be decades, which ends with deep damage to the nervous system.

Dwelling on the rash of this stage, we note that the tubercles are smaller in size when compared with gummas, both in their size and in the depth at which they occur.

Tubercular syphilis is determined by palpating the thickness of the skin and identifying a dense formation in it. It has a hemispherical surface, the diameter is about 0.3-1 cm.

Above the tubercle, the skin becomes bluish-reddish in color. The tubercles appear at different times, grouping into rings.

Over time, necrotic decay forms in the center of the tubercle, which forms an ulcer, which, as we have already noted, leaves behind a small scar upon healing. Considering the uneven maturation of the tubercles, the skin is characterized by the originality and diversity of the overall picture.

Gummy syphilide is a painless dense node that is located in the middle of the deep skin layers. The diameter of such a node is up to 1.5 cm, and the skin above it acquires a dark red tint.

Over time, the gum softens, after which it opens, releasing a sticky mass. The ulcer that forms can exist for a very long time without the necessary treatment, but it will increase in size.

Most often, such a rash is single.

Symptoms of secondary syphilis in the photo appear more aggressive and pronounced. The rash affects large areas of the skin and can lead to inflammation in the lymph nodes.

At the first stage of infection, an ulcer appears that is regularly shaped and very hard, like cartilage or cardboard. If you look at photographs of syphilis at different stages of the disease, it has different rashes.

In the first stage, only the area of ​​infection is affected. That is why treatment at the initial stage of the disease is considered the most effective.

If a man becomes infected through sexual contact during genital contact with a sick woman or during anal sex, then signs of the disease appear on the head of the penis or at its base.

For homosexuals who indulge in oral sex, the mouth may become the site of infection. Very often, the first appearances of syphilis in these places appear in the corners of the mouth and resemble seizures.

However, unlike cracks caused by vitamin deficiency, syphilitic ulcers do not cause peeling, are painless and have a very hard bottom.

After a few days they pass and the disease moves to a new stage.

Primary signs of the disease.

What are the first signs of syphilis? In the case of the classic version of the Lewis disease, this is chancre and enlarged lymph nodes. By the end of the primary period, patients are concerned about the following symptoms:

• headache
• general malaise
• pain in muscles, bones, arthralgia
• heat
• decreased hemoglobin (anemia)
• increase in white blood cells

Syphilis rashes that affect the scalp are considered especially dangerous, since skin lesions in these areas are not always immediately detectable.

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• The first three to four weeks after infection, bacteria spread through the bloodstream through the patient’s blood and lymph. This is the incubation period during which bacteria multiply.
• Once a sufficient amount has accumulated in the body, the primary signs of the disease begin to appear. A red ulcer with a dense base forms.
• The lymph nodes that are located near the affected area are enlarged.
• After some time, the ulcer may disappear. However, you should not think that self-cure of syphilis is possible. Bacteria continue to multiply in the patient's body, moving throughout the body through the lymph. The patient may have frequent headaches.

• Some experience fever or malaise, which some patients mistake for chronic fatigue.

• The disease progresses, moving into the second stage. At this stage, a pale rash and ulcers appear on the patient’s skin. Lymph nodes are dilated. The patient's body temperature rises. Periods of exacerbation alternate with asymptomatic progression of the disease.

Primary signs of syphilis in women:

• chancre is located on the labia majora and minora
• primary syphiloma may appear on the cervix, in the anus
• the rectal mucosa can also become the site of chancre

Sometimes primary syphiloma appears in the pubic area, on the abdomen, thighs; extra-genital localization of chancre - fingers, tongue, lips. Important: when chancre appears in the cervical area, the primary signs of the disease go unnoticed. Primary signs of syphilis in women

• Syphilis is transmitted to a child through the mother's umbilical cord blood. This is an acquired disease. Infection through household means is also possible.
• The patient’s personal hygiene items (washcloth, towel, bed linen, toothbrush), as well as the use of the patient’s utensils, pose a danger to the child.

Chancroid is a sexually transmitted disease that is widespread in the United States, Mexico, Southeast Asia and Africa. In Russia, this disease is rare and in most cases is diagnosed in people who have traveled abroad and become infected there. It also occurs in men and women who have had unprotected sex with sick foreign citizens who came to our country.

Causes of the disease

The disease is infectious in nature. The causative agent of chancroid is Haemophilus ducreui. This streptobacilli is resistant to chemicals and low temperatures; it dies at temperatures above 40 °C. The way a person becomes infected with a bacillus is through sexual contact with an infected person. Streptobacillus Haemophilus ducreui can enter the body during vaginal, anal and oral sex.

In 50% of cases, chancroid (as venereal disease is often called) develops after a single sexual contact with a carrier of the infection. The risk of infection increases several times if there are scratches, wounds, or ulcers on the mucous membranes of the genital organs and on the skin of the oral cavity of a healthy partner. Through them, the causative agent of chancre easily penetrates inside.

In women, the disease is often of a nature, so they, not knowing about the pathology, continue to infect other partners. Sexually transmitted infections are common among prostitutes, those who use their services, and members of sexual minorities.

In medical practice, there are isolated cases of domestic infection with chancroid. They are observed in laboratories and clinic workers when people do not comply with safety rules (streptobacilli from the test material can enter the body of a health worker through a wound on his finger if he does the analysis without gloves).

Symptoms of chancroid

With an infectious venereal disease such as chancroid, symptoms do not appear immediately, since the infection has an incubation period, which can rarely last 1-2 days or can extend to several weeks. More often this period is 3–5 days for men and 10 days for women.

When the latent (hidden) period passes, the first symptom of chancre appears at the place where the Haemophilus ducreui bacillus has penetrated - a small swollen spot that stands out against the background of the skin or mucous membrane with its bright red color. Soon a nodule appears in the center of the spot, containing pus inside. After 2–3 days, the vesicle bursts and turns into an irregularly shaped ulcer.

At first, the formation is small in size (2–3 mm), then it begins to increase in depth and breadth and reaches a diameter of 1.5 cm. The photo helps to imagine what an ulcer (chancroid) looks like.

Unlike the one that appears with syphilis, when palpating (feeling) this formation, the patient feels its soft structure. The ulcer not only bleeds, but also hurts. The bloody-purulent contents of the formation fall on the tissues adjacent to it, as a result of which smaller chancres also form on them. Located around the very first ulcer and merging with it, they represent a large red spot, some parts of which are just beginning to develop, others are already secreting pus and blood.

Primary and secondary signs

Primary spots with this venereal disease form on different parts of the genital organs:

• in the area of ​​the labia minora and majora;
• chancre at the entrance to the urethra in women;
• on the inside of the foreskin;
• on the penis in the frenulum area;
• in the coronary sulcus;
• in the navicular fossa (behind the external opening of the urethra) in men.

Less commonly, ulcers are located in other parts of the body. In such cases, they are called extragenital primary chancre. They form on the mucous membrane of the mouth, as well as in the anus. In the latter case, they look like deep cracks. These signs appear when infection occurs during oral and anal sex.

Sick people who neglect the rules of hygiene develop secondary chancre on the buttocks, pubis and inner thighs. This occurs due to the fact that the purulent contents of the ulcers spread over areas of the body adjacent to the genitals. Sometimes the carriers of the infection themselves transfer the pathogens from one area of ​​the body to another with their hands.

Primary ulcers form over 2–4 weeks, then their purulent bottom is cleared and the chancre gradually heals, leaving a small scar in its place. All primary and secondary ulcers heal within a month from the moment of appearance if a person consults a doctor in a timely manner. If the disease is ignored, then it moves to the next stage, affecting the lymphatic vessels and nodes.

Chancroid spreads with severe variations in a number of infected men. Sometimes the spot heals in the center or on one side, but continues to grow along the periphery and can reach the anus, perineum, pubis and thighs. This phenomenon is called serpiginous, or creeping.

With the gangrenous version of chancre, the ulcer grows deeper and reaches the cavernous (cavernous) bodies of the penis. Symptoms of this disease are: increased body temperature or chills, severe bleeding of the genital organ, as the cavernous bodies are increasingly destroyed. Some patients may develop sepsis (blood poisoning).

If gangrene with chancroid spreads to other areas of the skin and affects them, this type of disease is called phagedenic. If small ulcers reach the mouth of the sebaceous glands, then we are talking about follicular lesions.

Diagnosis of chancroid

The victim should contact a medical facility when he notices the initial signs of chancre on his body. An experienced dermatovenerologist can identify a sexually transmitted disease during an external examination of the patient’s affected organs. But until the ulcer begins to bleed and fester, the symptoms of the disease can be confused with signs of other sexually transmitted infections. Therefore, specialists use various methods to correctly diagnose chancroid, using materials taken from ulcers as the subject of research.

With microscopy, in smears stained with Ziehl fuchsin, it is possible to see Haemophilus ducreui rods between the leukocytes, located in groups in the form of a school of fish, and to diagnose a venereal infection of chancroid. A bacteriological culture analysis of the contents of the ulcers may be performed.

Sometimes doctors perform an autoinoculation test for infection. To do this, a scratch is made on the patient's thigh or abdomen and bloody discharge from the ulcers is introduced into it. A watch glass is placed on top and, having secured it to the skin, the changes are observed. It will be possible to identify the causative agent of chancroid in a few days from the ulcer that develops in the scratch.

If a sexually transmitted infection is suspected, a blood test is performed for serological reactions. This test makes it possible to distinguish the disease from syphilis, since the ulcers of both diseases are similar. When the causative agent of chancre enters the blood, PCR (polymerase chain reaction) is considered an effective research method. Patients are often asked to undergo additional tests for other sexually transmitted infections, since they can enter the human body along with streptobacilli Haemophilus ducreui.

Treatment

Once a diagnosis of chancroid is made, treatment begins immediately, as the infection develops quickly. The disease is treated with broad-spectrum antibiotics for 1–2 weeks. During this time, it is possible to defeat it when the patient goes to a medical facility early. Among the effective drugs are Clarithromycin, Tetracycline,. If these antibiotics are contraindicated for a person with chancroid, he is prescribed non-toxic sulfonamides (Sulfalen, Etazol).

Under no circumstances should people self-medicate, since only a doctor can prescribe this or that medicine and its exact dosage. Along with taking medications, local remedies are used to treat chancroid:

• ulcers are disinfected with antiseptic solutions (Furacilin);
• lubricated with liniments containing sulfonamides;
• treated with anti-inflammatory ointments, streptocide emulsions.

Thanks to local therapy, it is possible to heal ulcers and quickly eliminate the external symptoms of an acute venereal disease.

When diagnosed with chancroid, to strengthen weakened immunity, patients are prescribed immunostimulants (Echinacea purpurea, Schisandra), multivitamin complexes and a diet high in vitamins. During the treatment period, it is prohibited to drink alcohol and have sex. If a person has infected his regular partner with chancroid, he should also undergo treatment, even if he has not yet shown signs of infection.

If you turn to doctors late with complications and an advanced form of the disease, a person will not be able to recover from it with antibiotics alone. In these cases, doctors resort to surgery. If a person with a chancre has concomitant HIV, the venereal ulcer cannot be cured completely. Having recovered, the patient should be observed by a doctor for 6–12 months and take samples for serological reactions, because if he is not careful, he can become infected again.

Complications

Severe forms of chancre or ignoring its treatment can lead to a number of complications. These complications are:

Phimosis develops when the foreskin of the penis swells and its opening narrows. The head of the genital organ is hidden under the flesh, and through a narrow opening, pus accumulating under the skin is released, in which chancre sticks are located.

If the head of the penis is exposed and the foreskin swells behind it, then we are talking about a complication of a sexually transmitted disease such as paraphimosis. With it, the tissues of the head of the penis are compressed by the swollen foreskin. The result of paraphimosis can be gangrene of the glans penis.

Lymphangitis (inflammation of the lymphatic ducts) is observed when the causative agent of chancre penetrates the nodes. This complication occurs in women on the outer surface of the labia and in men on the back of the penis. The vessels swell and become painful to the touch.

Often in humans, the consequences of infection are manifested by regional lymphadenitis or bubo (inflammation of the lymph nodes). With chancre, an enlarged lymph node can form an adhesion to the skin or to another node. The skin above the inflammation becomes bright red. In a number of sick people, the buboes dissolve quickly. In other cases, they fester, burst with the release of thick pus and blood, and the ulcers scar over time.

All complications of chancre cause a person a lot of trouble. Therefore, you should go to the doctor at the slightest suspicion of infection.

Prevention

People who actively have sex with different partners can never be sure that this infection will bypass them. But with strict adherence to certain rules, it is not difficult to avoid the disease chancroid; its prevention consists of strengthening the immune system and maintaining personal hygiene. Casual sexual intercourse should be avoided, and if it occurs, be sure to use a condom. Workers in laboratories and medical institutions should examine patients with suspected chancroid and perform tests only while wearing gloves.

Treatment of chancroid can be carried out both on an outpatient basis and on an inpatient basis. During the treatment course, the patient is prohibited from any sexual contact. All sexual partners of the patient who have certain symptoms should undergo examination, as well as proper therapy. When treating solid infiltrate, targeted antibacterial drugs are used. Treponema pallidum, which causes the appearance of hard chancre, has increased sensitivity to the penicillin group of antibiotics. The most effective treatment for hard papules is systemic injections of penicillin.

Chancre - treatment and prevention

In practice, so-called “short” penicillins are used to treat chancroid:

• Systemically prolonged bicelin.
• Durant drugs of the penicillin group, for example, extensillin.
• Reserve group drugs if an allergic reaction to penicillin occurs. Tertracycline, streptomycin, azithromycin, fluoroquinolones and macrolides.

Treponema alba is the causative agent of syphilis, the symptom of which is chancre. Preventive protective methods can neutralize Treponema pallidum within two hours after infected sexual contact. The corresponding procedure can be carried out in any medical institution. All areas of possible damage should be treated with antibacterial external preparations. Intimate relationships with a healthy partner can be practiced only after a week-long course of preventive measures and a repeat venereological examination.

Soft chancroid - treatment of sexually transmitted infection

The predominant diagnostic method is studies aimed at detecting the pathogen in the oozing fluid. Often, a culture method for growing bacteria is used for this. Often the course of the disease is complicated by concomitant sexually transmitted infections.

For those infected, the main treatment for chancroid involves the need for antibiotics such as kanamycin, azithromycin, gentamicin, doxycycline, ceftriaxone and tetracycline. They are schematically taken together with antibacterial drugs - biseptol and sulfadimethoxine. The choice of one drug or another depends on the general condition of the patient and the severity of the disease. Of no small importance is the location of the chancre, which must be treated with a weak solution of potassium permanganate in combination with antibiotic ointments. Patients should also take B vitamins.

During the treatment of soft ulcers, the patient will have to avoid sexual intercourse and alcohol consumption. It is necessary to change underwear several times a day, since ulcerative lesions of chancroid tend to separate fluid. It is advisable to boil the patient’s bed linen for a long time after washing.

After a full course of treatment, the patient is required to take monthly tests for six months and undergo a full examination for sexually transmitted diseases. It is pointless to use folk and home methods to treat soft formations; this can lead to serious complications and sexual dysfunction.

Complications include phimosis, gangrenosis, paraphimosis and scarring of genital tissue. In the most advanced cases, fistulas may occur, and the inflammatory process affecting the subcutaneous layers can lead to chronic stagnation of lymph and cause blood poisoning.

Regardless of whether it is a hard or soft chancroid: how to treat it and what medications to take, only a dermatovenerologist can say with confidence. The main measure to prevent soft ulcers is protected sex and abstinence from casual sex.

20.10.2018

Syphilis is a serious disease that is transmitted not only through sexual contact, but also through household contact. Several stages of the disease affect the skin, genitals, nervous system and bones.

But do not despair, medicine already knows the cure for syphilis and guarantees complete relief from it, provided that you go to the hospital in a timely manner. As a rule, the course of treatment for this sexually transmitted disease lasts 2-4 weeks.

Syphilis can be:

• congenital (develops in the fetus in the womb);
• household (infection occurs from the use of common things);
• sexual (occurs during sexual intercourse with an infected partner).

Important: a condom protects against HIV and unnecessary pregnancy, but does not protect against syphilis!

A spiral-shaped bacterium called Treponema pallidum is the causative agent of syphilis. It is so inconspicuous that it is difficult to see even with a microscope, when the biological samples being studied are painted with a special paint. This microbe is distinguished by its high reproduction rate and all methods of treating syphilis are based on this property of the bacterium.

Treponema pallidum dies when it dries out, but in a humid environment it can live for a long time. Therefore, the danger of being infected lies not only in sexual intercourse, but also in household items - toothbrushes, towels, spoons, etc. This microorganism can only exist in a living organism. Once beyond its limits, he dies.

Important: transmission of syphilis through blood transfusion is impossible: when blood is preserved, the treponema is killed, and donors are carefully examined.

The insidiousness of syphilis lies in the absence of any obvious manifestations at the initial stage. The presence of this sexually transmitted disease can only be shown by specific tests. This is where the greatest danger of the disease lies. However, if the disease is identified, treatment can proceed without complications or consequences.

Symptoms of syphilis

The incubation period after infection lasts 3-6 weeks. After this, an exacerbation stage occurs, lasting approximately 4 weeks. The symptoms of syphilis are as follows:

• lymph nodes enlarge;
• ulcers about 2 cm in size or less appear in the place where the infection has penetrated;
• red spots appear on the skin;
• swelling appears around the manifestations;
• the ulcers begin to secrete pus.

When the acute stage passes, the disease “hides”: specific discharge from the genital organs disappears, the ulcers go away and scar, the skin becomes pale. The latent phase begins.

Syphilis injections

Injections are given intramuscularly in the upper outer quadrant of the buttock and only rarely are they given intravenously. Most often, this venereal infection is treated with penicillin. This antibiotic is the most effective medicine against syphilis. After an intramuscular injection, the drug begins to act instantly, but it is eliminated from the body almost as quickly - this is its disadvantage. Treatment with penicillin lasts exactly 2 weeks, during which injections are given to the patient every 3 hours.

It is also possible to prescribe the drug Bicillin, which differs from penicillin in the concentration of active substances and composition. This is the most popular domestic drug today.

The frequency of injections is as follows:

• Bicilin-1 - once a day;
• Bicilin-3 - twice a day;
• Bicillin-5 - two to three times a week.

Bicillin-1 does not accumulate in the body, so it is not prescribed using the short method. It cannot be used for:

• syphilis, which is already more than a year old;
• pregnancy, in its second half;
• congenital syphilis;
• death of hair follicles (alopecia areata);
• the appearance of whitish spots on the skin (leukoderma);
• problems with hearing and vision (neurosyphilis).

If the infected patient is allergic to penicillin, then other drugs are prescribed to treat syphilis:

• Tetracycline. Injects twice a day. Prohibited for the treatment of children under 8 years of age, as well as for kidney disease and poor hearing;
• Ceftriaxone. Injections are given once a day. The drug is less effective compared to penicillin derivatives, but when prescribed, the patient does not need to be hospitalized;
• Doxycycline. It is administered intramuscularly twice a day. During treatment, the patient needs to be in the sun as little as possible. This medicine for syphilis negatively affects the development of the skeletal system, so it is not recommended to inject it into children.

Treatment of syphilis: tablets

As a rule, treatment with tablets is prescribed to people who have been in close contact with an infected person. Pills are also prescribed to patients who cannot be given an intramuscular injection due to tissue hardening from frequent injections. Tablets are often prescribed half an hour before injection with a new drug.

Important: the maximum dose of tablets per day should not exceed 750 mg!

The most commonly used tablets are:

• Rovamycin. The dose is determined by the doctor. Do not use for liver complications or pregnancy. An overdose may manifest itself in the form of vomiting or nausea.
• Sumamed. Negatively affects the liver and kidneys. Treatment is carried out at an early stage of syphilis, often used as an additional remedy to stronger drugs.
• Cefotaxime. Dosage varies depending on the stage of the sexually transmitted disease and the patient's response to the medication. Prohibited if you are allergic to penicillin.
• Amoxicillin. Weakly effective compared to penicillin and its derivatives. Do not take together with antibacterial drugs.

How to treat syphilis using traditional methods

Various herbs can be used to treat venereal disease only as an addition to basic medications.

Important: treatment of syphilis exclusively with folk remedies is ineffective and leads to death!

Before treating syphilis with medicinal herbal infusions, you should definitely consult a doctor who will tell you whether such treatment will help you or, on the contrary, will cause harm.

Homeopathy in the fight against syphilis

Wondering what drugs to treat syphilis, many people turn to homeopathy. Homeopathic tablets were used in the fight against sexually transmitted infections three centuries ago. The principle of operation of such treatment is simple: “stimulating” the immune system, which should “retaliate” to the substance that causes the symptoms of treponema in a healthy person.

As a rule, preparations that contain iodine or mercury in small quantities are used for this purpose. The patient takes medications alternately: a week with iodine, a week with mercury.

The active substance is diluted with water in a ratio of 1:100. Many doctors argue that such a small dosage can bring neither benefit nor harm to the patient.

Scheme

It is impossible to treat syphilis in the same ways due to the diversity of its stages and forms. Therefore, the effectiveness of treating an infected person directly depends on the regimen chosen by the doctor. Moreover, the doctor almost never “copies” the scheme, always taking into account a lot of circumstances that affect the speed and quality of treatment.

Important: you cannot treat syphilis on your own, even relying on a diagram!

Having consulted a doctor, the patient receives an individual scheme according to which he will be treated and which is based on the following conditions:

• tolerance to certain drugs;
• forms and stages of syphilis;
• features of the patient's life;
• how old is the patient;
• what diseases (including chronic ones) does the person being examined have;
• what physical and moral condition the patient is in.

Scheme No. 1: preventive treatment

Bicillin-1 - 2 injections of 2 million 400 thousand units. It is used if syphilis does not respond to treatment using an ultra-short regimen.

Scheme No2: ultra-short

Benzathine penicillin G or Retarpen - one-time in the amount of 2 million 400 thousand units. Effective only within 24 hours after acquiring the infection. This scheme is a treatment for syphilis with one injection. It is used without even waiting for test results, relying only on the patient’s story about “dangerous” sexual intercourse. It should be noted that many doctors are skeptical about this “one-shot” procedure, arguing that such a “trick” does not work these days.

Scheme No3: specific treatment

Bicillin-1 or Retarpen, or Benzathine penicillin G - 6 injections of 2 million 400 thousand units. Effective for early latent syphilis, as well as for secondary recurrent syphilis. For primary and secondary “fresh” syphilis, the same drugs are injected, with the same dosage, only 5 times a day.

Scheme No. 4: trial course of treatment

Potassium or sodium salt of penicillin - every 3 hours, 8 times a day, for two weeks. The dosage of one injection intramuscularly is 400 thousand units. If such treatment brings a positive result, it means there is syphilis in the body. Additional examinations are carried out and other, stronger treatment regimens are prescribed.

Scheme No. 5: prevention during pregnancy

Bicillin-1 - twice a week, 1 million 200 thousand units. A total of 7 injections.

How to treat old syphilis

Penicillin drugs, which act for a short time, are recommended for the treatment of old (late) syphilis due to their effective penetration even into hard-to-reach foci of infection. This property is especially valuable if treponema has affected the central nervous system and the medicine needs to be deeply absorbed into the cerebrospinal fluid.

Treatment of late syphilis is intravenous injections of penicillin for 2-3 weeks. Daily dose: 24 million units. In parallel with it, probenecid is injected 4 times a day at a dose of 1-2 million units. If this method is ineffective, penicillin is replaced with ceftriaxone: 2 weeks, 1 gram per day intramuscularly.

In cases where a person has damage to the optic nerve, treatment begins with taking vitamins B12 and B6 (intramuscular), retinol (dragees, oil solution or drops), as well as nicotinic and ascorbic acids. After the “platform” has been prepared for the eyes, treatment with penicillin begins according to the above scheme.

Important: syphilis, which was treated with penicillin according to the regimen chosen correctly, disappears forever!

It should be noted that if dangerous microbes have caused complications (syphilis of the heart muscle, stomach, neurosyphilis, etc.), then ordinary injections of antibiotics are of no benefit. In this case, doctors transfer the patient to endolymphatic administration of drugs. Surgeons open a lymphatic vessel on the back of the foot and inject an antibiotic into it, just like a regular vein. The advantage of this method is the direct “delivery” of penicillin to the affected areas: nerve endings, bones, joints, etc.

Scheme for endolymphatic treatment of syphilis

• 7 infusions per day for primary syphilis;
• 12 infusions over two days for secondary fresh syphilis;
• 12 infusions over two days for early latent syphilis plus 5 days, every 4 hours the antibiotic is administered intramuscularly.

After this course, patients are prescribed another 4.5 million Bicillin-5 intramuscularly. For weakened patients, Thymalin is additionally administered to strengthen the immune system.

No matter how syphilis is treated, the process is invariably accompanied by bismuth preparations: bismoverol or bijoquinol, as well as iodine-containing drugs that resolve syphilitic bumps and speed up metabolism in the body.

Bottom line

Properly selected medications and strict adherence to all doctor’s recommendations make it possible to recover from syphilis forever.

The main thing is not to self-medicate and take the treatment process seriously.

Description:

Chancroid (venereal ulcer, third venereal disease) is an acute venereal infection that manifests itself as painful multiple genital ulcers and inflammation of the lymph nodes.

Chancroid is endemic in Africa, Southeast Asia, and Central and South America, and in some regions the disease predominates over syphilis. Chancroid is registered in the UK, Portugal, Italy, USA and other countries. At least 1,000 cases of the disease are reported annually in the United States. In many large cities of the United States, chancroid has become an endemic disease; However, under-reporting of this infection is widespread. In the countries of the former Soviet Union, chancroid is rare; infection mainly occurs during travel abroad.

Symptoms:

The incubation period of chancroid usually does not last long: 3-5 days in men and up to 10 days in women. Sometimes it can last longer, up to several weeks, but this is rare. Sometimes the incubation period of chancre, on the contrary, is shortened to 2 or even 1 day.

After the end of the incubation period, a small swollen spot of bright red color appears at the site of introduction of the pathogen - streptobacilli; a nodule soon forms in its center, in the place of which a vesicle with purulent contents soon appears. After a few days, the blister opens, and in its place a chancre itself forms - a painful ulcer with a diameter of several millimeters to several centimeters and an irregular shape.

The ulceration formed at the site of introduction of the pathogen quickly grows, increasing both in diameter (up to 1-1.5 cm) and in depth. An ulcer with chancre is bleeding and sharply painful, which distinguishes it from hard chancre that occurs with syphilis. The base of the ulcer and it itself are soft to the touch (hence the name of the disease “chancroid”), the uneven edges of the ulcer are surrounded by a swollen inflammatory rim, the bottom is covered with a purulent-bloody coating. Getting on the surrounding tissues, this purulent discharge provokes the formation of new multiple ulcerations, smaller in size, so that single ulcers with chancroid are rare. New small ulcers are usually located peripherally around a large ulcer. Merging, they form a new large, as if “creeping” ulcer. Most often, with chancroid there are many ulcers at the same time, which are in different stages of development.

Most often, primary chancre (ulcers) with soft chancre are formed in the genital area:
- on the inner layer of the foreskin
- in the coronary sulcus
- on the frenulum of the penis
- sponges of the urethra
- in the scaphoid fossa
- on the labia majora and minora

But other options for their localization are also possible - the so-called primary extra-sexual manifestations of chancroid (that is, manifestations that occur outside the genital organs).

Their location depends, first of all, on the circumstances under which the chancroid infection occurred. Sometimes, although quite rarely, an ulcer forms in the anus (here it is a deep painful crack), even more rarely - on the oral mucosa, if the infection occurred during anal or oral sexual contact. In addition, cases of the occurrence of primary extra-sexual manifestations of venereal ulcers in connection with the professional activities of medical workers have been described. In such a case, ulcerations caused by chancroid may be located on the hands or fingers.

In addition to primary extrasexual manifestations, the formation of secondary extrasexual manifestations of chancroid is possible. Such chancres occur when purulent discharge from a primary ulcer flows onto nearby areas of the skin of the inner thighs or onto areas of the body distant from the genital organs. Most often, the patients themselves are “to blame” for the appearance of secondary chancre, who literally transfer the infection from the affected genital organs to other areas of the body with their own hands.

The process of formation of chancres (ulcers) lasts, as a rule, 2-4 weeks, after which the bottom of the ulcer is cleared, and after some time healing occurs with the formation of a small scar. In uncomplicated cases, healing occurs within 1-2 months. after infection, if the course of the chancre was complicated, then more time is required for the ulcers to heal. In the absence of full treatment for soft chancroid, the next stage of soft chancroid becomes damage to the lymph nodes and blood vessels, which leads to numerous complications.

Sometimes the ability of chancroid to grow peripherally becomes pronounced, and the so-called serpiginous occurs. Its peculiarity is that the ulcer, scarring in the center, spreads from the genitals to the pubis, thighs, perineum and anus.

An ulcer with chancroid can spread not only around the periphery, but also in depth. With such growth of the ulcer, a gangrenous type of chancre may occur, which is considered the most severe and fraught with especially dangerous complications.

With the gangrenous type of chancroid, the ulcer penetrates into the depths, exposing the cavernous bodies. The patient develops fever, body temperature rises, and septic phenomena develop; Sometimes destruction of the cavernous bodies occurs, which is accompanied by severe bleeding. In some cases, the gangrenous process takes on a long, progressive course, affecting large areas of the skin. In this case we are talking about phagedenic chancre.

At the initial stage of chancroid development, complete cure of the patient is not difficult. Of course, only a venereologist should carry out treatment. In the absence of serious complications and advanced disease, cure occurs within 7-10 days. However, the human body does not develop immunity to chancroid, so re-infection remains possible.

Complications of chancroid
The most common are: lymphangitis (inflammation of the lymphatic ducts), lymphadenitis (inflammation of the lymph nodes), (narrowing of the opening of the foreskin), paraphimosis (infringement of the head of the penis by the narrowed foreskin).

Lymphangitis is observed on the dorsum of the penis and on the outer surface of the labia. Manifests itself in the form of a compacted painful cord. The skin over the thickened surface is hyperemic and swollen, palpation is painful. In rare cases, inflammatory nodes appear along the painful cord, which can suppurate and then turn into bubonules (Nisbet's chancre).

The most typical sign of chancroid is regional lymphadenitis (bubo), which occurs 2-3 weeks after infection. characterized by acute unilateral enlargement of one or more lymph nodes fused to each other and to the skin. The skin above the affected lymph nodes becomes bright red. Inflammation of the lymph nodes may go away on its own after some time, and the resulting bubo will dissolve. Suppuration is possible: a fluctuation appears in the center of the bubo, and it opens with the release of thick pus mixed with blood. The resulting ulcer subsequently scars.

When there is swelling of the foreskin, phimosis may develop. In this case, the head of the penis cannot be exposed, and the pus that accumulates under the foreskin is released through a narrow preputial opening. Chancroid pathogens are found in purulent discharge.

With swelling of the foreskin located behind the exposed head of the penis, paraphimosis is possible. Its outcome may be gangrene of the glans penis due to compression of the tissues by the ring of edematous foreskin.

Causes:

The causative agent of chancroid is the chancroid bacillus Haemophilus ducreyi. The chancre stick was first described in 1887 by the Russian scientist O. V. Petersen. In 1889-1892, it was studied in detail by the Italian dermatologist A. Ducruy and the German dermatologist P. G. Unna. After these three research scientists, the chancre stick received its second name - streptobacillus Ducray-Unna-Petersen.

The chancroid rods are located in the lesion in a rather characteristic way: in parallel rows. Researchers compare the arrangement of chancre sticks in a smear of pus with “chains” or “schools of fish.” The streptobacilli themselves have rounded ends and a constriction in the middle, their length is 1.5-2 microns, and their thickness is 0.4-0.5 microns. Infection with chancroid usually occurs during sexual contact, when streptobacilli enter either damaged skin or the mucous membrane of the genital organs.
Chancroid rods tolerate low temperatures well, and they are also quite resistant to various chemicals. However, at temperatures above 40°C, streptobacilli die.

Infection occurs through sexual contact, and persons providing sex services play an important role here. In US sailors and military personnel who have sex primarily with prostitutes, chancroid is detected more often than syphilis. Contribute to infection of damaged skin or mucous membranes. Very rare, but non-sexual transmission is possible. There are reports of children and health care workers becoming infected.

Treatment:

For treatment the following is prescribed:

As a rule, chancroid can be cured quite easily and completely with the help of antibiotics or sulfonamide drugs. Most often, antibiotics are used, the action of which is aimed at destroying not only streptobacilli, but also Treponema pallidum - the causative agent of syphilis.

The course of treatment for a venereal ulcer is usually 1-2 weeks, after which the patient must visit a doctor prophylactically for six months in order to avoid relapses and the development of other infections, the most dangerous of which is syphilis.

In addition to general antibiotics, local antibiotics are used in the treatment of chancroid, usually in the form of ointments, which help eliminate the clinical symptoms of chancroid, which cause pain and discomfort to the patient.
In addition, in the treatment of chancroid, restorative and immunomodulatory drugs are used as supplements to the main treatment.
If a patient turns to a venereologist with an advanced form of chancroid, which has already caused complications, then sometimes the doctor has to resort to surgical intervention. Therefore, treatment of chancroid must begin at the earliest possible stage of the disease.