Congenital Syphilis - Dermatology Simplest self work for Dermatology department

1. Name : Francis Sharon Jessy
Group : 12
Topic : Congenital Syphilis
Teacher: Pazylova Baktigul

2. DEFINITION
•syphilis is a sexually transmitted disease caused
by infection with the bacterium treponema
pallidum
• congenital syphilis is defined as disease
transmitted from a pregnant mother to her fetus

3. Congenital Syphilis
Hepatomegaly
Rash
Ostitis ,
Metaphysitis,
Periostitis
Wimberger sign
Nasal
discharge
Hydrops
fetalis
Petechial rash
Necrotizing
funisitis
within the matrix
of
the umbilical cord

4. CLASSIFICATION
Congenital
syphilis
Early
Direct bacterial
infection
Within first 2 years
Late
Phenomenon of
hypersensitivity
Later than 2 yrs

5. PATHOLOGY
• Major fetus- small perivascular inflammatory foci &
lymphocytic infiltrate  reduced growth of parenchymal
cells & fibrosis.
• Placenta- heavy, bulky, pale, greasy.
Placenta HPE-
1. Necrotizing funisitis
2. Villous enlargement
3. Acute villitis
• Stillborn fetus- macerated appearance with collapse of
skull, protuberant abdomen with enlarged liver and
spleen, haemorrhagic bulla.

6. Early congenital syphilis
• Primary stage – absent (blood borne)
• Baby – Preterm/full term
Early cong.
syphilis
Lack
manifestations -
birth
rhinitis,
pneumonia,
failure to thrive
Classical
presentation -
birth
Wizened, pot
belly, hoarse baby
looking like old
man, withered
brown skin &
runny fissured
nose.
More prone for
intercurrent
infection

7. Manifestations Of Congenital Syphilis -
Early Congenital Syphilis
• Anemia
• Oedma or wasting
• Fever
• Failure to thrive
• Rhinitis or snaffles is an early symptom
• Profuse mucopurlent discharge and nasal congestion
• Skin eruptions
• Erythematous appearance

8. • Mucuocutaneous lesions occur around the nose, mouth,
anus and vulva –moist and readily produce fissuring and
bleeding
• Excoriations and ulcers are common in the genital &
perinatal region & on the face
• Around the mouth may lead to radiating scars called
“rhagades”
• Condyloma latum , which are flat, raised plaques with moist
surfaces,occur around the anus and female genitals ;it is
usually found in later infancy, between 6 month 2 yrs.

9. Late Congenital Syphilis
• Interstitial kerailts
• Pain,photophobia&lacrimation
• Vascular infiltration of deep layers of cornea which
presents a ground - glass appearance& later
become opaque.
• Secondary iridocystitis

10. Skin Lesions
• Vesicobullous rash, symetrically , palms and soles-
earliest & specific sign.
• Also known as Pemphigus syphiliticus
• Lesions are contagious, also seen around oral cavity,
trunk, buttocks, and genitilia.
• Few weeks later, a papulosquamous rash may appear.
Usually involve the face, mouth, anterior nares, buttocks,
palms & soles.

12. Diagnosis
• History collection
• Physical examination
-Hepatomegaly
-bone inflammation
For mother
-fluorescent treponemal antibody absorbed test
-Rapid plasma reagin(RPR)
-VDRL

13. • Bacteriology
• Eye examination
• Lumbar puncture( csf studies- increased protein)
• Radiology – Wimberger's sign( litic lesion in the
upper aspect of tibia)

14. Complication
• Blindness
• Deafness
• Deformity of the face
• Nervous system problems

15. Treatment
•Intravenous crystalline penicillin G 100,000-
150,000U//kg/day-im
•Erythromycin 15mg/kg/day for 10 days