Solid Shankr where appears. Shankr: species, characteristics, treatment

Habitat - gum pockets. The structure and shape of the oral trichomonads is similar to intestinal single-cell. The difference is a smaller body size and shorter the indulgent membrane. This microorganism is often detected in patients with dental clinics with obvious diseases of the oral cavity: with gingivitis, periodontal disease and caries. In people with healthy teeth and with complete adventure (no dental units), the presence of trichomonade is rare.

Compared to the other types of trichomonads, the mouth belongs to the weakest and less threatening, but in the human body it is more common.

Vaginal Trichomonas (Trihomonas Vaginalis)

This form of unicellites is distinguished by large sizes (up to 30 microns), aggressiveness and ability to disguise. Finding into the human body, unicellular imitates the flat layer of the epithelium, which helps protect against aggressive impacts of the immune system.

The threat of infection consists in the fact that the vaginal trichomonade interacts well with other infectious urogenital bacteria, which penetrate the inside of the unicellular and in this way they are protected from the effects of the immune system and drugs, provoking various pathological processes (especially in the female organism). These may be microorganisms: chlamydia, candidate, gonococci, cytomegalovirus and herpes viruses. In addition to protection, bacteria get good transport services. Trichomonov's mobility provides them with rapid movement on all departments of the genitourinary system.

Fixing in the cells of the urinary tract mucosa, trichomonas provoke an inflammatory process. The products of their livelihoods begin to gradually poison the body and drain protective functions. Gradually, unicellites are moved to the genitals and blood rods. Well masked for lymphocytes and platelets, which makes a difficult diagnostic procedure.

All types of trichomonade have a non-peculiar shell. This gives them the opportunity to protect against the effects of antibiotics. It can be destroyed only with special anti-protocouplen preparations.

Ways of infection of women with vaginal trichomonade

Trichomonas in women manifests themselves stronger symptoms. At an infected man, the symptoms may be absent, so the strong floor often does not suspect the presence of a problem and behaves carelessly, increasing the risk of infection for a woman.

A woman's vaginal trichomonade is infected in domestic conditions.

through the beet of the toilet;
public places in the form of pools and the soul;
the use of common towels, wash and hygiene;
fitting someone else's clothing (especially underwear);

The risk of infection in everybody mainly depends on the conditions in which Trichomonad will fall. The fact is that a unicellular occurring in the environment can live a day only with high humidity and a temperature not higher than 40 ° C. Straight sun rays and dryness are able to kill a microorganism for 10-20 minutes., For example, the use of someone else's wet towels increases the risk of infection.

After hitting trichomonas in the body of a woman, it additionally requires certain conditions that contribute to the rapid reproduction.

Factors contributing to the development of trichomoniasis

neglecting standard hygiene rules:
frequent indiscriminate sex women:
the period of the menstrual cycle:
pregnancy period.

These factors contribute to a decrease in protective forces and form favorable conditions for the development of pathogenic agents, which include vaginal trichomonas.

After entering the mucous membrane, trichomonades begin to allocate substances that allow them to firmly fix on its walls, as well as enzymes that contribute to the splitting of the mucous cells. All this provokes inflammatory processes that are accompanied by appropriate symptoms.

Symptoms of vaginal trichomonosis in women

After hitting the body Trichomonov, women have symptoms can manifest a couple of days and even months. Everything will depend on the state of immunity and the availability of other infectious diseases.

Trichomoniasis is manifested in the form of vulvovaginite, urethritis, cervicitis and bartolinite. Symptomatomics may be a low-rise or have an acute character. In the acute course of the disease, the following symptoms are noted;

cordial discharge of green or yellow color with foam consistency;
irritation of the mucous membrane, accompanied by burning or itching;
in case of damage to the mucous, ulcers and erosion are formed;
discomfort when urination;
discomfort with sexual intercourse;
pain syndrome at the bottom of the abdomen.

The amount of selection and manifestation of other characteristic features will depend on the stage of the inflammatory process. For example, at the initial stage, the symptoms are strongly pronounced. The chronic form of trichomoniasis is accompanied by a washed symptoms and minor discharge. The exacerbation occurs a couple of days before the start of the menstrual cycle, and after pokes.

The first form of trichomoniasis lasts about 2 months. Then the symptoms becomes low, but it does not speak about cure. The disease acquires a chronic form, which without a certain treatment for years is capable of practically not to exercise.

Consequences when ignoring the problem

In cases of ignoring problems with the presence of trichomonodas in the body, the consequences may be the most diverse: the exhaustion of the body, infertility, cancer, etc. It is determined by the fact that when trichomonates hit the body, it brings with you other pathogenic bacteria that could find from infected man. By absorbing them and defending them, Trichomonas safely transports them to the body of a new carrier. Even if an infected person has previously passed a course of treatment from infection, only bacteria in tissues died. The absorbed retained their livelihoods and moved to a new carrier.

Trichomonada is a living organism that is capable of absorbing nutrients, leukocytes and red blood cells, and this strongly undermines the human immune system. In addition, the products of the livelihood of microorganisms provoke intoxication of the entire body. As a result, a patient has observed: exhaustion, oxygen fasting, anemia, weakens vision and blood-forming fabrics are destroyed.

For a woman, the complications described above are complemented by a new list:

endometrite is formed - inflammatory diseases of the uterus;
salpingitis - inflammation in the fallopian tubes;
the ovaries are inflamed, forming spikes;
pyelonephritis;
cystitis;
severe pregnancy with complications and spontaneous miscarriages;
postpartum complications;
the bakingbind of the child may end it with inferiority in development;
infertility.

Avoiding such consequences will help timely diagnosis and a complete course of treatment.

Diagnosis of the disease

Trichomonads skillful masking. Embiring epithelial cells, they are often misleading the laboratory technicians. Determine trichomonad at first sight only experienced researchers. This helps: a specific "dirty" background formed by the coking flora, an enlarged number of leukocytes and the presence of cells with enlightenment near the nucleus.

To form an accurate diagnosis, several diagnostic methods are used. About each of them in more detail.

First of all, the doctor conducts a patient's survey on the presence of symptoms and the image of an intimate life. Already at this stage, an experienced specialist can suspect trichomoniasis.
Further, the external inspection of the genital organs should be followed. Attention is drawn to the peculiarities of the appearance of the vulva, the consistency and nature of the selection.
After an external examination, a specialist takes a common smear from the patient's vagina. This is a quick test to establish the number of microorganisms and the severity of the inflammatory process. As a rule, with the results of such an analysis can be found after half an hour.
Next, the smear taken on bacteriological examination. During this study, the secretions taken from the urethra and vagina provide favorable conditions for the reproduction and growth of bacteria that are in them. This method not only allows you to identify trichomonas, but also to choose the best antibacterial drugs.
PIF helps to determine the presence of antibodies in the body that have been developed by the immune system to combat infection. But this method has one drawback. If the patient suffered a disease earlier, its immunity has already produced antibodies, and it is impossible to determine the formation of antibodies. Therefore, such a diagnosis is more suitable for patients who first encountered trichomoniasis.
The most accurate studies include the PCR method. It allows you to achieve accuracy in a diagnosis of 95%. This method is consigned to take biological material, from which the DNA of the microorganism is further extracted, followed by a laboratory study. Thus, it is possible not only for the presence of trichomonas itself, but also the pathogens associated with it (mycoplasm, chlamydia, ureaplasma, etc.).

After installing an accurate diagnosis, a specialist selects a treatment scheme that will depend on the launch of the case and associated infections.

Medicia treatment

In the standard treatment diagram of trichomoniasis use anti-trouserds. Most often it is metronidazole (trichopol) or tinidazole. If other pathogenic microorganisms were found besides trichomonas, a specialist may assign clion-d. Each of these drugs has its own application and contraindication scheme. Consider more.

Application Metronidazole

The components of the drug have a depressing effect on trichomonacea genetic apparatus. Due to this, the biological processes of one-cell milk gradually cease, which is destructive for the microorganism.

Application scheme is as follows. On the first day, the patient takes 1 tablets with a repeated 4 times (the drug is powered by plenty of water). Starting from the second day and over the next six, the dose decreases - 1 tablet of 3 reception.

Contraindication to use may serve as an individual sensitivity of the body to the drug, as well as a period of pregnancy and lactation.

Application Tinidazole

Tinidazole refers to the same group of drugs as metronidazole. The mechanism of exposure to microorganisms is also identical, but has 2 application schemes. Tablets can be taken once - 4 pcs. (Each 500 mg), and you can stretch the course for a week - 2 times / day is accepted 1/3 tablets.

Among the contraindications: a period of pregnancy and lactation, increased sensitivity to the components of the medication, existing bleeding disorders.

Application Wedge-D

This drug relates to combined medicines. It has 2 drugs - metronidazole and antifungal micronazole, which are taken in equal parts. Such a composition of the medication makes it possible to effectively deal with the patient of mixed infections of bacterial origin.

The drug is produced by vaginal candles, and used - 1 candle \u003d 10 days (larger effect can be achieved if you put a candle for the night).

It is worth noting that the above-described drug treatment should be carried out under the supervision of a specialist who will control efficiency. To control treatment with counter-syrtromonade drugs, a specialist takes from the urethra and vagina of the smears, which are investigated under a microscope for the presence of trichomonia. This procedure is repeated for 2-3 months. Each smear is taken in no later than a third day from the end of the menstrual cycle.

How to improve the effectiveness of treatment?

To achieve maximum effect in treatment, the patient needs to comply with additional rules.

Treatment is carried out both partners at the same time. It is better if the partners will be examined by one specialist. Otherwise, it may turn out that one to cure, and the second is not yet. Then all efforts will be in vain.
Throughout the treatment, sex contacts are excluded.
If the organism has concomitant infection of urinary organs of inflammatory origin, this should be taken into account when prescribing drugs and treat simultaneously with trichomonade.
Mandatory condition - compliance with hygiene rules:

for daily arms, antiseptic agents are used in the form of furaciline solutions or potassium permanganate (the economic soap is well suited);
compliance with the rules of the movement of the hand during the arms - movement is repeated from the vagina in the direction of the rear pass, otherwise the infection of the urethra can not be avoided;
the underwear should be replaced daily;
use only individual hygienic accessories (towels, washcloths and soaps).

In addition to these rules, you can take advantage of the recipes of traditional medicine, but necessarily after consultation with a specialist.

Recipes of traditional medicine

When diagnosing trichomoniasis in the patient, people's peoples are not initially applied. It is determined by the fact that the use of folk remedies may not give an initially positive effect, and during the period of application the time will be lost and the disease will turn into a chronic form. It is possible that the inflammatory process in the urinary system provoked another infection. In this case, the treatment must be sealing comprehensively.

The use of folk agents is more suitable for patients with a chronic form of trichomonosis. This will make it possible to remove disturbing symptoms and increase the gap between relapses.

The most efficient folk remedies include the following recipes:

➡ The composition is made of glycerol and garlic juice with a proportion of 20: 1. It is applied to the bandage or gauze, turn into a shape of a tampon and introduced into the vagina for 4 hours.

➡ Tampons with the use of honey. But it is worth noting that some specialists are against such an application. It is believed that honey can be used in integrated therapy with antibiotics.

To remove the itching and moisturize the mucous membrane will help the sea buckthorn oil.

➡ Washing genital organs tincture from the root of Khrena will help speed up recovery. This plant has a good antibacterial property.

During the use of funds from traditional medicine, it is necessary to understand that there may be a concomitant disease in the body. Therefore, the survey at a specialist is mandatory. Otherwise, the uncontrolled application of various missiles can only be aggravated by the position and put even greater hurt by their body.

Prevention

In order to prevent trichomoniasis, general rules are used against all infectious diseases transmitted by the sexual way (syphilis, chlamydia, gonorrhea, etc.). This is regular control of the gynecologist, the use of contraceptives, the exclusion of frequent change of sexual partners, the timely treatment of other infectious diseases associated with the urogenital system, compliance with all the rules of hygiene and proper nutrition, which will contribute to the strengthening of immunity.

Unfortunately, not everyone is trying to protect themselves from various diseases. It is for this reason that some people become victims of the most dangerous diseases. Some such ailments are capable of leading even to death. One of these dangerous diseases is syphilis. At the initial development of syphilis on the body of a sick person appear shankra.

What is primary syphilis?

Primary syphilis Called the original stage of syphilis, which develops after infection with a pale trone. Primary syphilis begins with formations on the skin, as well as with the introduction inside. With primary syphilis on the body there is a solid chancre. These formations can be formed both on the skin and on the mucous membranes.

Currently, modern medicine has allocated some differences regarding the clinical picture of primary syphilis, compared with those manifestations that were seen earlier.

For example, earlier at the initial stage of the development of syphilis, Shankre was formed in a single amount of almost 90% of patients. At present, chancresses began to appear on the skin in the number of two formations. In addition, Shankra began to increase in their size.

In another article on our site we discussed.

Solid Syphilic Shankr - Starting Stage of Syphilis

Primary Shankra At the very beginning, externally represents a stain of red, which over time turns into erosion.

The main signs of solid syphilitic Shankra:

The diameter of the spots on the skin or mucous membrane can reach 5 cm.
Form flax oval.
Education has clear boundaries.
Color spots red or bard.
The presence of a yellow purulent laid.

Solid syphilic Shankr is never accompanied by pain or itching. Many people simply do not notice him because of this on their own body. If you slightly press the side of the stain, then yellow liquid can be isolated.

Saving a solid Shankra occurs within a month. After that, this formation on the body does not leave any visible traces. But despite this, it is worth noting that the disappearance of the solid Shankra indicates the one that the disease can take a hidden form.

Among women

Syphilical solid Shankre in women is a very dangerous venereal disease. Even at the initial stages of its development, syphilis refers to a serious infection for sexual partners, and at the launched stage, the disease may cause fatal outcome.

So that the treatment gave some positive result, Shankre in a woman needs to be revealed at the initial stages of its education.

The period of the manifestation of Shankra after infection usually takes about 3 weeks. In women, a solid syphilitic Shankre can be formed on sex lips or clovers. However, it is much more difficult to detect education if it is localized inside the vagina. Such Shankr can only be seen by chance when gynecological examination. It is for this reason that one should not be neglected by regular visits to the female doctor.

In men

Solid syphilic Shankre in men, as a rule, manifests itself in the area of \u200b\u200bthe genital organ. To be more specifically, it strikes the penis head, a corrosion and scrotum.

If a man is a supporter of non-traditional sexual orientation, the formation may appear in the area of \u200b\u200bthe anal opening and in the mouth. In the size of chancres, men can be both miniature and gigantic. And it is worth noting that the most contagious is the miniature chance, the diameter of which reaches only a few millimeters.

The first symptoms of the manifestation of solid syphilitic Shankra can manifest As 2 weeks after infection, and after 3 months. A solid Shankre is usually formed in that place, which was subject to the introduction of pale treponama - the main provocator of the disease.

Most often, the fields of infection are genital organs. However, there are currently more and more occurrence when Shankre manifests itself on the stomach, hips, face and fingers.

External distinctive features of solid syphilitic Shankra:

The formation of meaty erosion.
The diameter of education can reach several cm.
Erosion has raised edges.
The stain has a burgundy or red shade.
From erosion there is a liquid, which externally makes it lacquered.
The basis of education is a dense infiltration.

Photo

Types of syphilitic Shankra

As a rule, Syphilic Shankr is divided into the following types that differ from each other with symptoms:

Giant hard chance Most often is formed in place, which is characterized by an abundant fatty tissue under the skin. The value of such a chancra can reach the size of the children's palm.
Dwarf solid chancre It is characterized by its size that can reach up to the size of the poppy seed.
Diphestic solid chancre It is distinguished by the fact that its surface is covered with a gray film, like diphtheria. This species is found very often.
Cork solid chance It is formed in those areas of the body, on which the drying of the separated (nose, lips, face) is easily occurring.
Slitual Shankr looks like a crack. Most often this species is formed in the corners of the mouth, between the fingers and in the area of \u200b\u200bthe rear pass.

Solid Shankre (primary syphil) is a dense painless ulceration of meat-red color, which is covered by a scarce serous separated. Erosion or ulcer is formed in places in the introduction of the causative agent of syphilis (pale trepoon).

General

Mention of lesions resembling a solid Shankre is found in the works of Avicenna, in Chinese manuscripts dated 2600 BC. e. And in the Japanese book on medicine of 808. e.

Descriptions of clinical manifestations, which are similar to syphilitic, are also found in the writings of hipporate, Galen, Celsius, Dioscride, Plutarch and Archigaen.

The description of the signs of solid Shankra belongs to A. Fournier, who was engaged in the study of Syphilis (the first work of the Fournier on this topic dates back to 1857).

It was Fournier who allocated 9 signs from a solid Shankra, described rare cases of its appearance on the chin, heel and cheek as a result of household infection.

Solid Shankre Almonds was first described in 1861. Diday, and LEGENDRE was engaged in studying in 1884.

Shankre Eyes was first described in 1850 by Rikor, who allocated the chance of the century, the clarity edge and conjunctiva.

The rare case of solid Shankra Eha was described in 1878 Hulot.

Forms

Solid Shankre, depending on the size and form, is divided into solid chancres:

Giant, which are localized in places with a significant amount of subcutaneous fatty tissue (pubis, belly and inner surfaces of trouble and in magnitude can reach 40 - 50 mm. May be accompanied by gangreyanization and phagenedenism (ulcer-necrotic process).
Dwarf. The diameter of such Shankra does not exceed 1 - 3 mm, but with the help of magnifying glass, you can detect the presence of all characteristic features of the primary syphil. More often in women.
Diphestic. This type of frequent solid Shankra is covered with a necrotic film of a grayish shade.
Cork. This type of Shankra is localized in places where the separated breathes easily (face area, penis barrel and sometimes belly), and can resemble pyodermic elements (, eccima).
Slimmed. Form resemble a crack and in most cases are located in small folds of the skin (the corners of the mouth, the folds between the fingers, the area of \u200b\u200bthe rear pass).
Erosion Shankra Folmin. This type is most often located on the head of the penis or women's outer genitals, does not have a clear seal at the base and differs by the presence of a plurality of partially merging small sharp limited erosions.
Burns (combustofoform). Manifested as prone to expressed peripheral growth of erosion with a weak seal at the base, which in the process of growth loses the right outlines, and the bottom acquires the graininess and red shade.
Herpetyiform, which are similar to genital herpes on manifestations.

There are also atypical forms of solid Shankra:

Indecented swelling, which occurs on the extreme flesh or on sex lips. The affected area increases in 2 - 4 times, it becomes dense and can acquire a stagnant shinny shade. The defeat is distinguished by painlessness and absence of island phenomena.
Shankr-amygdalit, which is characteristic of a sharp, in most cases a one-sided increase of almonds. Almond acquires density, but there are no isgens characteristic of angina.
Shankr-Panarium. This chancre looks like a deep ulcer with a purulent-necrotic bloom and rugged edges, the skin around which will acquire swelling and a blue-red shade. Localizes on the distal phalangle of the finger of the brush (more often is affected by a large or index finger) and is accompanied by a sharp, "shooting" pain. In most cases, a consequence of professional infection (detected in, and pathologists) and is not diagnosed in a timely manner (the diagnosis is most often set after the appearance of rashes characteristic of the secondary period of syphilis).

At the location of localization, solid chancres are divided into:

File (amount to 90% of the total). Solid Shankre in women is most often located on sexual lips and rear spike (plot of mucous membrane in the vagina), and in men on the head of the penis.
Overseas, which can be partly associated with sexually infection (hips, pubic area). Can be located on any section of the skin and mucous membrane. 75% of cases of extragnenital chancro are localized in the head area, 7% - on the upper limbs, 6.8% in the anus area and 5% in the field of mammary glands. The shankr of the lips is usually localized on the red border of the lower lip.

Multiple Shankra is observed approximately 1/5 of the patients, but their number usually does not exceed 10. The multiplicity of primary syphil is associated with the presence of numerous small disorders of the integrity of the skin or mucous membrane in the patient at the moment of infection.

Causes of development

The solid Shankre is formed at the place of introduction into the body of pale treponama - the type of gram-negative spirochete, which are the pathogen of syphilis.

Pale Treplema refers to bonde anaerobam, which are capable of exist only in the absence of molecular oxygen in the habitat. On simple nutrient media, this pathogen is not cultivated, and it is multiplied in a very narrow temperature range - about 37 ° C.

In connection with these features of syphilis (LUES) transmitted:

In most cases, sexually The patient's sperm is contagious even if there are no visible pathological foci on the penis.
When blood transfusion and other contacts with the blood of the patient (injection with common syringes, general razors, toothbrushes and the like tools and accessories, damaging skin or mucous membranes).
In rare cases, the household (possible with a close contact with patients in the tertiary stage of syphilis if there are open syphilitic ulcers in patient or decaying syphilitic gums).
When breastfeeding (possibly in the absence of foci in this area).
When opening (a special danger is the corpses of children who had an early congenital form of the disease).

In the saliva of the patient's pale treponams only in the presence of rashes in the oral cavity.

A crucial role in the formation of multiple Shankra is played by concomitant skin diseases localized on genital organs.

Pathogenesis

Solid Shankr - the first syphilis manifestation, observed in 10 - 90 days after contact with the patient (on average after 3-5 weeks), which has contagious manifestations of the disease.

A solid Shankre develops from the appearance of a red tint spot, which in a few days begins to swell and convert to the delimited papul (a vulnerable education that rises above the skin level). After some time, papula turns into oval erosion or ulcers, the solid edges of which are clearly outlined, and the bottom is covered with crust or granulation.

When palpation, a dense nodular or laminated infiltrate is detected at the base of the resulting primary syphil. The density of infiltration depends on the location site of solid chancre - located on the cervix or on the head of the penis, the solid Shankre is characterized by a weakly pronounced infiltrate (the density is insignificant or absent). The pronounced seal is detected if the defeat affected:

area of \u200b\u200ban internal leaf of extreme flesh;
vernoe groove of the head of the penis;
area near the outer opening of the urethra.

The development of solid Shankra is distinguished by painlessness (pain is present only when the secondary infection is attached).

When perturbing in a few entrance gates, numerous solid chancresses are at the same stage of development (twin chancresses). When penetrating the pathogen, at different intervals, chancresses occur at different times and differ in the degree of maturity (successive solid chancres).

After 7-10 days after the formation of Shankra, the lymphatic nodes coming to the location of the primary syphil. Lymph nodes retain mobility, differ in dense consistency and painlessness.

After 2-3 weeks, serological reactions become positive, and for 3 to 4 weeks from the moment of the appearance of a solid chancre, all lymphatic nodes increase.

Approximately a week before the start of the secondary period in some patients there are prudent phenomena (weakness, headache, muscle pain, pain in joints and bones, fever), but overall health remains satisfactory.

Symptoms

The main clinical symptoms of the classical solid Shankra include:

erosion or ulcery, in which island phenomena is missing;
single education (85%);
the correct outlines of education (may be rounded or oval);
the presence of clear and hard boundaries of education;
the magnitude of the classic solid Shankra is 10-20 mm;
elevation of education over the surrounding surface (skin or mucous membrane);
the presence of a smooth shiny bottom (reminds lacquered);
the edge of the edge of education;
blossish-red shade of the bottom of the element;
the presence of a meager serous separated;
the presence of a plate, nodular or leaf-cooled density infiltration at the base of the detected element;
the painless nature of the defeat.

With a well-developed follicular apparatus and the spread of infection in the depths of the follicle, dwarf chancres develop, and the gigantic chance more often develop on smooth skin.

Without treatment, solid Shankr heals independently after 1 - 2 months after its education, however, this testifies to the further development of syphilis, and not about cure. On the site of the ulcers can form a scar, and erosion forms are taking place without a trace.

Diagnostics

The diagnosis of solid Shankra is placed on the basis of:

inspection, in which, with typical forms of the disease, diagnosis based on characteristic symptoms does not represent difficulties;
lab diagnostics, which allows you to identify the pathogen with any forms of the disease.

Laboratory diagnostics includes:

A dark-axis microscopy that allows you to detect pale trepanins in the lesion separated from foci (pale treponema is painted only by complex specific methods of color).
Polymerase chain reaction or DNA sensing, allowing to identify the only DNA molecule of the causative agent.
Methods of serological diagnostics, which are based on the detection of antibodies in the blood or liquor to the causative agent. Increicate tests (MRP with inactivated serum or plasma, RPR, Trust-test, etc.), which are distinguished by affordable, but low-sensitive, and more highly sensitive taps (Vasserman reaction, TPI, etc.).

Treatment

Since the pale treponema retained the sensitivity to the penicillin group, the solid chancro is treated with the help of antibiotics of this group. Synthetic antibacterial preparations of penicillin row (benzylpenicillin, ampicillin) are actively used.

In the case of individual intolerance of penicillin, erythromycin, tetracycline, ciprofloxacin, ophloxacin or in some cases azithromycin are prescribed.

Prevention

Preventive measures include:

the use of separate dishes and individual hygiene facilities;
exclusion of unprotected sex contacts and kisses with sifilis patients at a contagious stage.

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22.06.2017

Primary syphilis manifests itself in an increase in lymph nodes andsolid Shankra. What is solid chancre? it syphilis symptomswhich are round with a diameter of about one centimeter of ulcers on the body of the patient.

In color, they are red with blue, sometimes they are painful, but mostly the patient does not perceive pain in the place of erosion. First signssyphilisa In men: the formation of Shankra on the penis head, and in womensyphilis symptoms manifest on the walls of the uterus and on the external genital organs. Also, these ulcers are on the pubic, near the anal opening, in language and lips.

Syphilis develops quickly, and lymphatic nodes are first inflamed, and then educationsolid Shankra.

It may be resolved by itself, even without medication treatment, from one month to two. It passes almost without a trace, although if the ulcers are large, the stains of the dark color can remain.

Shankr at syphilis - This is the source of syphils, whichforms On the site of treponam in the body.

Shankr received its name from a French word, which means ulcer, erosion. In some infectious diseases there is SHAKR, but for the disease syphilis, this erosion is the first signsyphilisa In the first stage. Educationsolid chancra On the body later, a little more than 4 weeks, from the moment of infection with this disease. During this period, the source infection has time to get into many organs and in lymph, while begin to multiply, which causes an inflammatory process and cantemperature appear.

Types of Shankra

Classified by type, size, the number of ulcers on the body, the location of their location.

By type, Shankr shares:

erosive is erosion that affects the layers of the mucous membrane;
yazvnaya Shankr is ulcers that penetrate deep layers of fabrics.

According to the quantitative classification of Shankre to share on:

one is Shankr, which consists of one ulcers;
multiple is erosion, which consists of a variety of ulcers, and create a single wound.

Sofils of solid Shankra There are:

small (dwarf) - diameter less than 10 mm;
average - diameter of 20 mm;
large (giant) - 50 mm diameter and above.

The place of the appearance of solid Shankra on the body:

extgazenital - It is amazed by ulcers, anus, chest, throat, legs, gums;
genital - this is erosion,appearing on the genital organs of a sick person;
bipolar is chancresses that are simultaneouslyappear On the genitals and other parts of the body.

By the end of the primary period of syphilis, Shankre becomes a form of a disease that:

has localization in specific places, in the oral cavity and in genitalia;
has a numerous form;
does not affect internal organs;
pretty easily treated and leaves after myself the consequences.

Features of the development of solid chankra

People who have become infectedsyphilis infections and at the same time have reduced immunity, ulcerative defeatappears necessarily. Also, the formation of ulcers on the body occurs in chronic infections, toxicing the body and in the age reasons. Due to self-medicationsyphilisa Brutal erosions are formed, which, after attenuation, leave pigment stains and scars.

It begins to develop with redness, which does not cause itching and pain. After 48 - 72 hours from this redness begins to form a tubercle and Papula is formed. At this point, the epithelium from Shankra can be sewed, and the infected person first begins to feel pain.

In the next hours and the days of Symphoma becomes more, spreading around the circumference. On Papula begins to form a solid crust, under which an ulcer is formed. Over time, the crust is rejected and a sign of syphilis - solid chancre appears.

Shankra shape is slightly raised, with clear round edges. Sometimes these edges are oval form. Shankra smooth surface, sometimes it has a grayish flare, but basically the color of Shankra is red.

Shankra shape is different:

summary shape - This ulcer has clear boundaries. This ulcer grows into deep layers of fabric and retains its clear boundaries. This chancre is localized on the extreme flesh of the penis;
the shape of the plate or coin - Shankre is localized on the upper layers of the fabric and is on the sexual lips, the penis barrel, on the scrotum;
last shape - erosion has clear boundary lines and is located mainly on the head of the phallus.

Atypical chancre

In addition to hard Shankra, there is still atypical chance and a lot of his species:

indecented edema is a large seal that is formed on the extreme flesh of the penis, genital organs in women and in the area of \u200b\u200bthe lips on a person's face;
panarium is Shankre, which develops on the nails and does not heal for several months. Maybe even the rejection of the nail;
lymph nodes - increase in this period. Depending, in which part of the body, Shankre was formed, then the nearest lymph nodes are inflated;
bubon is a lymph node that has a moving shape and does not have painful signs and is closest to Shankra: on the neck of the patient if Shankre in the almonds, and the groin part of the body, ifshankre for a member , in the area of \u200b\u200bthe genital organs;
polyadenitis is inflammation and sealing of all lymph nodes, from that moment we can assume that the symptoms of secondary syphilis began to appear.

Complications for syphilis in the first period are very serious as for women, also serious consequences for the male part of the population.

Solid Shankre in the Women's Organization

In the female body arises:

on large and small sexual lips;
on the clitoris;
on the walls of the cervix;
in the area between the anus and the vagina.

On the walls of the vagina,solid SHAKKR during syphilis It occurs very rarely, since the acidity of the vagina is adversely acting on the trepony.

Very often, Syphilis Syphilis is formed on the cervix. This Shankre invisible and is diagnosed mainly in the second stage of the disease.

Over 10 percent of the syphilis of women in the first stage have a hard chance on the walls of the cervix.Syphilis Shankre It is detected only at the time of inspection of the uterus using medical equipment. This survey conducts a gynecologist or venereologist.

In the oral cavity, the Shankre is formed in the language, lips, soft heaven and almonds. Cases of occurrence of ulcers on gums, cheeks of fingers and chest.

Diagnosis of syphil

The diagnosis of syphilis consists of several types of surveys and analyzes:

serological diagnostics is the detection of bacteria by Treplen from the Solid Shankra scope. According to the results of this survey, the doctor establishes a diagnosis;
the immobilization reaction of treponama;
immunofluorescence reaction;
vasserman reaction;
microreactment on glass;
linked immunosorbent assay;
microprocipatition reaction;
reaction of passive hemagglutination.

Communication of solid Shankra with primary syphilis

Syphilis is a venereal disease that flows in a classic form.Syphilis Solid Shankre, the main sign of this disease. Solid Shankr, is a symptom of only primary syphilis.

Syphilis in the first stage of its development is manifested in increasing lymphatic nodes and solid chaver. Closer to the end of this period such symptoms are becoming:

general ailment state;
constant headache;
increased temperature;
pain in muscle tissues;
sounds and pain in the bones;
reduced hemoglobin;
significant increase in leukocytes.

Syphilic chancre It has properties to pass by itself and not to leave marks, therefore people who are engaged in self-medication can assume about the cure of syphilis.

This is a delusion, because the disappearance of solid Shankra is preceded by secondary syphilis, which is much more dangerous than syphilis in the first stage of development and the treatment of this type is much more complicated and longer.

Complications of syphilitic solid chankra

Complications of syphilitic Shankra may have other infections into Shankr, which leads to painful symptoms and pus accumulation in this place.

The reasons for the penetration of infection are several:

injury to Shankra;
non-compliance with hygiene;
disease diabetes;
HIV infection;
development in the body of tuberculosis sticks.

In the female organism develops:

syphilitic gangrena;
infectious vaginitis;
inflammatory bartholynitis;
endocervicitis cervix.

Complications in the male organism lead to:

balanitu;
balanopostitu Penis Head;
phymsu of extreme flesh;
paraphomy of the extreme flesh;
gangreese Penis Head;
phaginenism of the penis.

Treatment of syphils

At the initial stage, the task is to cure infection and do not give syphilis to go to the second stage.Solid Shankr, Treatment It must be carried out as early as possible.

The main drugs that are used in treatment are antibiotics of different groups and directions:

penicillins;
macrolites;
tetracyclines;
fluoroquinolones.

Together with antibiotics in the treatment process involved:

antifungal drugs;
immunomodulators;
polyvitamins;
probiotics.

The treatment scheme of syphil is prescribed the attending physician, on the basis of diagnostics and results of analyzes.

Under the course method of treatment, tetracyclines and bismuth-based drugs and iodine are added to penicillins. This complex of drugs is able to increase the effect of an antibiotic in the body.

With the diagnosis of syphilis, both sexual partners are treated.

At the time of therapy, the patient prescribes food, in the diet of which protein food and restriction in the consumption of fat and carbohydrates prevail.

During this period, smoking and alcohol use is contraindicated, and it is also necessary to reduce the physical activity on the body.

The main condition for high-quality treatment, it is observing the rules of personal hygiene and during the treatment period - not to have sex.

Treat Shankre to antibiotics:

EXTENTIONALLIN - intramuscular injeces, it is enough to carry out the procedure twice;
Bicyllin - injections, twice, after 5 calendar days;
Erythromycin - 0.5 mg to take 4 times a day;
Doxycycline - 0.5 mg to take 4 times a day.

For the local treatment of solid Shankra, a binding on chancra from drugs by benzylpenicillin and Dimeksid preparation.

It is necessary to lubricate syphilitic Shankr with heparin ointment, erythromycin ointment, ointment based on mercury and bismuth. Syntycinic ointment and leviversity ointment, contribute to the separation of pus from ulcers.

Shankra, which are in the mouth, need to rinse with solutions:

furacillina;
boric acids;
gramicidine.

Solid Shankre is a very important feature in the recognition of syphilis in the body. The earlier the infection in the body was revealed, the faster the treatment of the disease will begin, and the duration of the course of drug treatment may be minimal. In this case, the treatment of folk remedies and self-treatment is contraindicated.

Only a competent doctor will be able to diagnose and register the necessary treatment. The fulfillment of all prescriptions of the doctor, a healthy lifestyle, compliance with hygiene, will give a positive result in the cure of syphilis at the first stage of the development of the disease.

Clinical manifestations of primary syphilis are characterized by the presence of solid Shankra (primary syphil) and lesions of lymphatic nodes and vessels.

At the end of the incubation period, the first sign and the main manifestation of the primary syphilis period are developing and the main manifestation of the primary period of syphilis - primary syphil (synonyms: solid chancre, primary sclerosis, primary erosion, Ulcus Durum, Sclerosis Primaria, Sifiloma Primaria, Erosia Indurativa). Sometimes there are cases when the manifestations of syphilis are started after 3-3.5 months immediately from the rashes of the secondary period. This is the so-called "decapitated syphilis".

Solid Shankr (ULCUS DURUM) is an erosion or an ulcer formed at the site of introduction into the skin or mucous membranes of pale trepan. Erosive solid Shankr is observed in 80-90% of patients; The occurrence of ulcers contributes to the violation of the general state of the patient due to chronic diseases; in toxications; An elderly or early childhood, as well as non-compliance with the rules of personal hygiene or the very treatment of solid chancra by outdoor irritating means.

Solid Shankr is not a true primary morphological element of syphilis, since its appearance is preceded by the development of the so-called "primary sclerosis", which proceeds asymptomatic and, as a paradise, is not noticed by a patient nor a doctor. These changes begin with the appearance of a small red spot, which in 2-3 days turns into a slightly towering over the skin level semi-shaped painless, not a lot of flaky papul. After a few days, this Pula Pula is compacted and increased by peripheral growth. The crust appears on its surface, the erosion or superficial ulcer ("solid chancro") appears on its surface. Solid chancro has an oval or rounded shape, often geometrically correct, its boundaries are smooth, clear, the bottom lies on the same level with the surrounding skin, either downstream up (sieve-like erosion). The uncomplicated solid Shankra never happens undermined or stealing edges, which has an important diagnostic value.

The surface of the primary syphil is smooth, smooth, has a bright red color (the color of "raw meat") or covered with a dense dyed dull grayish yellow. Sometimes this flare is located only in the central part of Shankra. Between it and healthy skin remains red rim. In some cases, in red or grayish with a yellow background of erosion, especially in its central part, small point hemorrhages ("Petechial" Shankre) are visible. On the surface of Tshankra, there is a transparent or opalescent separated, which gives it a kind of mirror or lacquer. When irritating the bottom of Shankra Sea, the rosy separated becomes abundant, it contains a large amount of pale trepoon, which is used for diagnosis. When localizing in open areas of leather, solid Shankre is usually covered with a dense brown crust.

Based on the primary syphil, there is always a seal of tissue to be tissues, which was the basis of calling the primary syphil solid Shankrom. This seal is clearly limited from the surrounding tissues and several millimeters go beyond erosion or ulcers. The consistency of the seal is enealastic, when palpation resembles the cartilage of the ears. In shape it can be nodule, lamellar and fox tovoid.

A nodule seal has a semi-shape, clear boundaries, deeply penetrates the surrounding tissues. It is most often observed when the solid Shankra is localized on the inner surface of the extreme flesh and the Vernoy Grozde. At the same time, the seal can be seen with the eye (the symptom of "visor" and the "Tarzal vouch"). When it is located in the area of \u200b\u200bthe extreme flesh, the tissue of the hard chance of tissue can be scruvyed so much that their mobility is disturbed up to the development of phimosis.

The lamellar seal resembles the base under the base of Shankra coin. It is most often observed during the localization of Shankra on the outer surface of the prepared bag, in the penis barrel, small and large sex lips. A sheet seal is supplied as a sheet of tight paper, most often it can be observed when the solid Shankra is localized on the head of the penis.

The subjective sensations in the field of primary syphilians are usually absent, although sometimes it is quite painful.

The dimensions of the solid chancre are usually small, and its diameter on average is 10-20 mm. Very small (dwarf), diameter of 1-3 mm or large (giant) chancres (up to 40-50 mm) are also found. Shankra's dwarfico usually arise in areas of leather with a well-developed follicular apparatus when the fan of the follicle infection is distributed. Dwarf chancres are especially dangerous from an epidemiological point of view, as it is difficult to detect and can be a source of infection. Giant chancres are most often observed on the skin of the pubic, the bottom of the abdomen, and the surface of the surface of the hips, forearms, face. Having achieved certain sizes, solid Shankr does not have tend to perform peripheral growth.

Solid chancres are solid and multiple. Multiple chancresses occur simultaneously or sequentially. For the simultaneous development of multiple solid chancres, the patient must have several skin defects or mucosa, contributing to the penetration of pale treponia (on the presence of concomitant diseases with itching and mass, maceration, trauma of the skin, etc.). Multiple solid chancresses occur sequentially with many multiple unlimited sexual intercourse with a pain of the contagious form of syphilis. These chancresses distinguish between the size and degree of seal.

Primary syphilians arising from the patient at the same time on two far away from each other parts of the body (for example, on genitals and breasts, red binding lips, etc.), are called bipolar chancres. In the occurrence of bipolar chancres, the usual flow of syphilis changes; The in the cuban and primary period is reduced, serological reactions in the blood becomes positive.

Primary syphil can be localized on any area of \u200b\u200bleather and mucous membranes, where conditions are created for infection. There are genital, perigeni and extregnitative solid Shankra localization. More than 90% of patients, solid Shankr localizes the smiling of the genitals. In men, solid Shankre is most often observed in the cornerwent, on the inner and on a rifted leaf of the extreme flesh, head, less often on the trunk or on the base of the penis, especially when using condoms. It is possible that the intraetral arrangement of solid Shankra, which is localized in the area of \u200b\u200bthe area of \u200b\u200bthe pan, or near the outer stencil of the urethra channel, turning into the mucus of the stroke of the urethra. It is characterized by a limited seal in the distal part of the urethra, scarce serous with blood discharge, soreness when urinating and a specific increase in the laimy lymph nodes. Shankra healing can lead to a narrowing of the urethra. Intraetral solid Shankre needs to be depleted from urethritis of various etiology, with cats (especially with chronic gonorads), it is often CO.

In women, the primary syphil is localized on large and small sexual lips, in the area of \u200b\u200bthe rear spike, the clitoris, on the cervix, is very rare - on the walls of the vagina. It is believed that the solid cervical of the cervix is \u200b\u200bobserved in 8-12% of cases, however, apparently, it meets much more often than diagnosed.

Shankre in the field of the vaginal part of the cervix is \u200b\u200busually localized on the upper lip and around the outer opening of the cervical canal; It is a cut to limited rounded erosion with a smooth shiny, bright red or coated with a gray-colored surface separating serous or serous purulent ex Sudert. Inflammatory phenomena around erosion is absent. In the area of \u200b\u200bthe outer opening of the cervical canal, Shankr has a ring-shaped or sealing form and a significant seal.

Cases of industrial edema and the location of solid chancra on the mucous membrane of the cervix cervix are described.

Solid Shankre can be observed in the area of \u200b\u200bthe rear pass both in women and men, especially homosexuals. These chance are located in the area of \u200b\u200bthe anal folds, the external sphincter, the anal canal and rarely on the mucous membrane of the rectum. They may have a kind of typical syphilitic erosion or an atypical form. In the depths of the back folds, the primary syphil is a rocket-like or-shaped left form in the field of internal sphincter - oval. Slitual Shankre in the depths of the anal Skla Doc is very similar to a banal crack, from which it is sipped by a compacted base and incomplete closure of edges. Primary syphiloma in the area of \u200b\u200bthe rear pass is painful regardless of the act of defecation, but during the latter it can bleed. It can proceed with the phenomena of the proctitis and sometimes requires differential diagnosis with an ulcerated hemorrhoidal zas scrap, a polype and even a rectal cancer. Regional lymph adenitis with chancre anal area is not observed in all patients. Solid Shankre in the field of direct sini is detected only with a rectal mirror or rectoscope.

Extgazenital chancres can occur on any section of the skin and mucous membranes and are found in 1.5-10% and more sifilis patients. They are single and multiple, in contrast to genital shankra, they take the form of infiltrated ulcers faster, are marked by greater soreness, a long-term flow of flow and accompanied by a significant increase in regional lymph nodes. Extracts Talnal primary syphiloma is most often localized on the red border of the lips, the breast, the fingers of the hands, in the lasty of the axillary depression, navel, century.

The solid breast chance is erosion or an ulcer of a conventional or crack-shaped shape, located in the nipple area or anala. It has a lamellar seal at the base, often covered with a crust, may be single or multiple, localized on one or both milk glands.

The localization of solid Shankra on the fingers of the hands is noteworthy, which is most often observed during the professional infection of medical workers (Surrur Gov, the obstetricians of gynecologists, dentists, pathologists), as well as with manual contacts (petting). Sometimes there is a combination of this Shankra with primary syphil genital organs (Bipolar Shankr). Tver Shankre is most often located on the distal Fa Langa of the fingers, especially II, can be typical or in the form of Shankra Panaritis.

Shankr Panariums is usually considered as an atypical form of primary syphil, since his clicking picture is extremely similar to the usual nation. Shankr Panarium begins with the formation of erosion or ulcers on the rear surface of the finger and the simultaneous seal of the fabrics of the fabrics. The ulcer differs in depth, the edges of its winding, sometimes hanging. The bottom is covered with mercury necrotic mas itself, the sections of dead tissue are often visible. Soft fabrics become not only dense, but as if they are soldered into one whole (from the skin to the periosteum). RAT infiltration does not have clear boundaries and extends to the entire Fa Lang, which is typical of other dactyls. The affected phalanx becomes edema, male-shaped swollen, the skin over it acquires a dark or crimson red. The similarity with Panarian increase spontaneous, shooting or pulsating pains, increasing at the slightest motion. Soon the elbow and axillary lymph nodes are increasing, the palpation of which is painful. Shankra Panarium is long (not delivered, months). The reason for the atypical flow of primary syphils on the fingers of the hands, apparently, is when the secondary infection is connected.

Diagnosis of Shankra Panarium is very difficult and often the diagnosis is established when secondary syphilides appear. In the presence of Shankra, panaritis in patients may develop ailment, fever, symptoms of general intoxication.

Two more forms of primary syphilitic shifts of fingers and brushes are distinguished - Dactylitis Luetica and Paronychia Luetica. They are distinguished by a minor bond with expressed inflammatory phenomena. Void may be absent. Chronic. Increased regional lymph nodes at both of these forms, in contrast to Shankra Panaritia, painless.

Special varieties of solid Shankra also include:

1) the burnive (combstiform) solid Shankr is an erosive primary syphilo pop, prone to a pronounced peripheral growth with a weak (sheet) compaction in the maintenance; As the erosion increases the border, it is losing the right outline, the bottom becomes red, grainy;

2) Folmane Balanit - Rare Clinical Vari Anth Shankra; On the head of the penis in men or on the outdoor genital organs, multiple minor erosion appear without a noticeable seal at the base; The woman contributes to the treatment of antibiotics in the time of the incubation period or their local nanion on Shankre in the first days of his appearance;

3) Herpetyform solid Shankre appears in the form of small erosions, located grouped on a small area; The seal at the base of erosion is expressed weakly; The clinical picture is very similar to the genital herpes.

There are some options for the flow of typical solid chancra, depending on the localization of the process and the anatomical features of the lesion sections. On the head of the penis, chancro usually erosive, has a rounded shape with a minor plate altitude; In the Vernoy Barrout - ulcerative, large indices with a nodule seal; On the bridle of the penis on - in the form of a tight with a seal at the base, bleeding during erection. Shankra localized in the area on the rug-border of the extreme flesh, usually multiple and often have a linear form. When arranged the first-flesh feathers on the inner sheet of extreme flesh, it makes it difficult to eliminate the heads from under it, radial naval and infiltrate appear at the base of Shankra rolled in the form of a plate (shankr).