Guideline for self-study of students for practical lesson

Module I . Dermatology and Venereology

Thematic module 8. Venereal Diseases

LESSON 21

Tertiary period of syphilis. Congenital syphilis.

1. Theme urgency

The tertiary period of syphilis develops in a small number of patients who were neglectful of treatment for syphilis or were not treated at all. Old and very young age, traumas (physical, psychic, medicamentous), chronic diseases and toxicosis, and alcoholism are conducive to the development of tertiary syphilis. This period of syphilis usually begins three or four years after infection; in the last decades, however, it has shown a tendency to develop in eight to ten years, and may even become manifest only in tens of years. Patients with tertiary syphilis are a rare occurrence in Ukraine. In tsarist Russia they were often registered, particularly in rural areas.

Syphilis acquired by the foetus in uterus from the mother is called congenital or prenatal syphilis.

The foetus is infected via the transplacental route by Treponema pallida, usually after the fourth month. The chances of infection are greatest in early syphilis, diminishing with time.

The clinical features of syphilis tend to become less severe during pregnancy. Repeated miscarriages, stillbirths, premature deliveries and neonatal deaths are good indications of syphilitic infection.

The only means of diagnosing syphilis in a pregnant woman, in the absence of clinical signs, is by a routine blood serological examination during the early and late stages of pregnancy. An early diagnosis followed by adequate treatment is the only effective way of preventing congenital syphilis.

2. Concrete Objectives:

Students must know:

1. Classification of tertiary period of syphilis.

2. Clinical features of tertiary period of syphilis.

3. Investigations of tertiary period of syphilis.

4. Diagnosis of tertiary period of syphilis.

5. Differential diagnosis of tertiary period of syphilis.

6. Classification of congenital syphilis.

7. Clinical features of congenital syphilis.

8. Investigations of congenital syphilis.

9. Diagnosis of congenital syphilis.

10. Differential diagnosis of congenital syphilis.

Students should be able to:

1. To collect the medical history of patient with tertiary period of syphilis.

2. To inspect the patient with tertiary period of syphilis.

3. To define tertiary period of syphilis and describe its respective clinical manifestations.

4. To differentiate eruptions of tertiary period of syphilis from those similar of others dermatoses.

5. To define congenital syphilis and describe its respective clinical manifestations.

6. To differentiate sings of congenital syphilis from those similar of acquire syphilis and others dermatoses.

3. Tasks for self-study during preparation for lesson.

3.1. Theoretical questions for the lesson:

1. The course of tertiary period of syphilis.

2. Tubercles syphilid.

3. Gumma syphilid.

4. Pathogenesis and classification of congenital syphilis.

5. Syphilitic affection of the placenta and the foetus in congenital syphilis.

6. Congenital infantile syphilis.

7. Congenital syphilis of early childhood.

8. Late congenital syphilis.

The subject-matter: