What Are the Most Common Causes of Circular Rashes?

Syphilis is an infectious disease caused by Treponema pallidum. It is mainly transmitted through sexual intercourse and is a sexually transmitted disease. In three stages: one stage of syphilis. That is, the hard chancre, the incubation period of 2 to 4 weeks, dark red hard masses, shallow ulcers, cartilage-like hardness, and peripheral lymph nodes enlargement in the external genital area. Second stage syphilis. One to two months after the first stage of syphilis, symmetrical generalized rashes, spotted rashes, pimples, and pustules occurred on the skin and mucous membranes.

Syphilis rash

Overview of syphilis rash

A brief introduction to syphilis rash

Mucosal plaques, flat genital warts can occur and are highly contagious. third stage syphilis. Occurred 2 to 3 years or even 10 years after infection. The skin is a gum-like swelling, which can also involve bones, joints, heart, and blood vessels. It manifests as aortic inflammation, aortic insufficiency, and aortic aneurysms. Spinal cord dysentery, general paralysis (paralytic dementia). Syphilis usually develops as a secondary syphilis in 7-10 weeks after infection and half a year later. Early symptoms are influenza-like syndrome, systemic lymphadenopathy, and subsequent clinical manifestations, mainly skin and mucosal rash.

Characteristics of syphilis rash

Syphilis rashes are diverse and can resemble many skin diseases. Their skin lesions are generally characterized by a lack of conscious symptoms or mild symptoms. The rash is widespread and often involves palms and palms. Generally, the rash is mainly a red spotted rash that is widely distributed throughout the body. It is oval in shape and looks like soybeans. It does not fuse with each other and can disappear within a few days or weeks. In addition, the rash can be a copper-colored pimples, also known as papular syphilis. The pimples are hard, the rash spreads throughout the body, is densely distributed, and does not fuse with each other. It can disappear in a few weeks. If the center of the pimples is necrotic, an abscess can be formed, that is, pustular syphilis, and the damage is small.

Syphilis rash case analysis

Bowen-like papules are rare, and some information is extracted to learn with everyone:

Bowen-like papules that occur in the external genital area of men and women is a rare disease. But in the past 10 years, with the sharp increase in the incidence of sexually transmitted diseases, especially condyloma acuminatum, the incidence of the disease has increased. Clinically, the disease is often confused with the papular type in condyloma acuminatum, and is easy to cause misdiagnosis.

Causes of syphilis rash

The cause of Bowen-like papules is not fully understood. At present, there are several possible factors: HPV infection: In patients with Bowen-like papules, although the virus particles were detected in only V4 cases, and the papilloma virus antigen was present in the nucleus of a small number of cases, the electron microscopy Prove the etiology of HPV. More and more research data show that Bowen-like papulosis is closely related to HPV infection. Among dozens of HPV subtypes, the HPV subtypes associated with the disease include HPV6, 11, 16, 18, 31, 32, 33, 34, 35, 39, 42, 48, 49, 51 and HPV54. However, HPV16 type is the most common, with 63% reported. Therefore, Bowen-like papules are now considered to be a disease caused primarily by HPV infection. However, some cases do not have evidence of HPV infection. Candida infection and other infections such as herpes virus infection. Different stimulating factors act on benign primary damage and then the disease occurs.

In addition, because very few cases are often accompanied by other sexually transmitted diseases such as condyloma acuminatum, the incidence of the disease is often associated with sexual contact.

Clinical manifestations of syphilis rash

Genital Bowen-like papules mainly occur in young men and women around 30 years of age. The damage is located in the male and female external genitalia. The primary damage is pimples, 2-10mm in diameter, several or more. The pimples are flat or hemispherical, scattered, and a few can fuse into plaques. The color can be light red, complexion, brown, violet blue, light brown, or pigmented. The surface is mostly smooth, and some may have a small amount of thin scales or mild warts. In men, damage occurs mainly in the penis, foreskin, glans, and / or lacing, and a few are found in the scrotum. In women, damage is mainly found in the labia majora, labia minora, perineum. In addition, vaginal opening, groin, hairy skin of the pubic area and skin around the anus can also occur. Most patients have no obvious symptoms, but a few patients may have itching.

Histopathological examination of syphilis rash

Bowen-like papules are histopathologically similar to Bowen's disease, and are characterized by epidermal psoriasis-like hyperplasia, hyperkeratosis, and focal keratosis, obvious granulomas, disappearance of cell polarity, and atypical pneumonia Type of mitotic, and multinucleated, necrotic, atypical keratinocytes with poor keratinization. The dermal papillary layer is edema, the capillaries are curved and dilated, and there are chronic inflammatory cells infiltration around them. Chen Xiaoduan et al. Observed the pathological results of 15 cases of Bowen-like papules: microscopic epidermal keratosis, mild to severe atypical hyperplasia of the spinous layer, different cell sizes on the surface, deeper nuclear staining, and easy to see mitotic images Visible asymmetric schizophrenia, there are a few scattered hollow cells in the surface layer, and some of the spikes extend downward and widen.

Key points for differential diagnosis of syphilis rash

The main points of difference between Bowen-like papules and papular condyloma are: Clinical manifestations: The damage of Bowen-like papules is mostly multiple, and most of them are scattered. The appearance is smooth, and the colors are mostly light red, Brown, violet blue or brown, it is not easy to bleed after friction, the damage growth rate is slow, and it grows to a certain degree and stops growing, while papillary condyloma acuminata tends to occur in clusters. Carefully observe that the surface is rough and uneven. Red, easy to bleed after friction, its damage grows faster and keeps increasing. Acetic acid test: Bowen-like papules are negative for acetic acid test, while papillary genital warts are mostly positive. Histopathological characteristics: see above

Syphilis rash treatment

Bowen-like papules are mostly benign and usually do not require special treatment, but it is important to keep the area clean and dry. Although the disease is expected to resolve on its own or the damage gradually subsides after being stimulated by certain injuries, the disease can also develop into Bowen's disease, so it is necessary to pay attention to such patients. Based on pathological findings, the diagnosis was Bowen-like papules. Why is anyone still saying syphilis? Syphilis is diagnosed mainly by serum TPPA and RPR. The soft chancre appears as a superficial ulcer.