How to diagnose secondary syphilis?

Syphilis, as a type of sexually transmitted diseases, causes great pain to patients. It not only causes psychological pressure, but also makes patients overwhelmed and dare not go to the hospital for examination. However, once this disease is not treated, it will develop into secondary syphilis. So, how to diagnose and check secondary syphilis?

Diagnosis basis for secondary syphilis:

1. Medical history: A history of non-marital sexual contact or a history of spouse infection. There may be a history of primary syphilis, usually occurring between 6 weeks and 6 months after infection or 6 to 8 weeks after the appearance of hard chancre.

2. Various rashes such as rose rash, papules, flat condyloma, palmoplantar syphilis rash, mucosal spots and moth-eaten hair loss, general discomfort, swollen lymph nodes.

3. Dark field microscopy: Treponema pallidum can be found in the exudate of flat condyloma, wet papules and mucosal spots.

4. Serological tests for syphilis: For example, RPR test, TPHA test or FTA-ABS test are all strongly positive.

Differential diagnosis:

Condyloma acuminatum: Condyloma acuminatum is a sexually transmitted disease. More than 95% of it is caused by unsafe sexual intercourse. Its incubation period is 2-3 months. Its appearance is a cocks-like, fungo-like or cauliflower-like rash. Compared with pseudo-condyloma, it will be slightly pointed and harder. At the same time, it will be more fragile and easy to bleed when encountered. If a vinegar white test is performed, the papules will turn white.

Vitiligo: Skin lesions are depigmented spots, often milky white or light pink, with smooth surface without rash. The boundary of the white spots is clear, the border pigment is increased compared with normal skin, and the hair in the white spots is normal or white.

Drug eruption: Skin rash is not obvious, similar to a large area of burns with debris. On the outside, the skin seems to be very healthy, but if you gently rub it with your fingers, a large area of the epidermis can be peeled off

In addition, it should be distinguished from diseases such as psoriasis, lichen planus, folliculitis, impetigo rose toy , and thrush.

Laboratory tests for secondary syphilis:

1. Dark field microscopy: Second-stage rash, especially flat condyloma, wet papules and mucosal spots, is easy to detect Treponema pallidum. At the skin lesions, tissue exudate or lymph node puncture fluid was scraped with a slide, and active Treponema pallidum was seen.

2. The syphilis serological test (non-Treponema pallidum antigen test and Treponema pallidum antigen test) was strongly positive.

3. Biopsy examination of Treponema pallidum. For example, using Warthin-starry method or Levoaditis method or fluorescent antibody staining sexshop , Treponema pallidum can be found, dark brown, with a spiral structure, and is located around dermal capillaries.

4. The Unheated Serum Reagin USR is also a modification of the VDRL antigen xxl dildo , and its sensitivity and specificity are similar to those of VDRL.
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