Diagnosis of syphilis

The diagnosis. The primary period. If you have any erosion in the genital research should be done on a pale Treponema. In case of negative result of the study should be repeated after 24 hours, during which apply lotions of sterile izotoniceski solution of sodium chloride. With repeated negative results are exploring punctat regional lymph node. Serological reactions in the primary period of syphilis is not decisive as they become positive only in 3-4 weeks after the appearance of a hard chancre. The differential diagnosis is conducted with soft chancre, cancer, bubble deny, cancriformis gangrenosum, acute ulcer of the vulva and other diseases.
Secondary period differs polymorphism rash: roseola, papules, pustules with the characteristic properties (see above), and the presence of leukoderma, specific alopecia (secondary recurrent syphilis), the possibility of destruction of internal organs, skeletal and nervous systems, and therefore is a complete examination of patients, including examination of the cerebrospinal fluid (especially when recurrent secondary syphilis). Serologic test for syphilis-positive (PB, PB in the cold, sedimentary reaction; with questionable results RV using new serologic test for syphilis: IBT - reaction immobilization pale treponem and REEF - reaction of the immune fluorescence). Pale Treponema usually easily found in erosive the papules, a wide condylomas. Differential diagnosis is carried out with taksidermiya, psoriasis, pink deny, the parapsoriasis, Atami, hemorrhoids, scaly skin disease, alopecia, and other diseases.
The tertiary period differs destructive nature of damage to the skin, mucous membranes, internal organs, skeletal and nervous system. Characteristic rash are bumps and gum (see above), in the discharge of which is to detect the pale Treponema very difficult. The diagnosis is confirmed by serological reactions (see above). The differential diagnosis spend with tuberculosis lupus indurativnyy tuberculosis skin, vasculitis, and other diseases.