Gumma 2ry stage Chancr e

Localized mass e` extensive necrosis caused by allergic

Reaction of the tissue to spirochetes .
10-15 years .

o: Single Or multiple .
!ite:any organ(rare in L.s)
Size:large(up to 10 cm in diameter)
"!
Shape: Irregular .
Pain: according to organ & site
Colour:grayish yello# centre$caseation)
"% &grayish periphery (i!rosis) .
Consistency: "u!!ery (gumma).
#Caseation e$tends to surace epithelium
Producing gummatous ulcer ch% !y:
Margin :Irregular d.t simultaneous
destruction & healing at &arious site.
Edge : punched Out .
Base :Indurated.
Floor : yello'ish (co&ered e% caseation).
Draining L.Ns : (ot aected.
causes o necrosis (caseation) :)
"elati&e central ischemia (*+O).
,elayed hypersensiti&ity reaction .
)))))))
-). months .
&iffuse or patchy mucocutaneous lesions .
1-Sin lesions: a! "lo#ecia ( loss o hair ).
$!%etilligo ( 'hite patches o s/in ).
c!Sin rash &-
#usually symmetrical & !ilateral more in palm &
soles o eet
#ormed o macules ( lat !ro'nish area )0 papules
(ele&ated on 1 surace) pustules ( inected papules )
d!Condyloma lata
#occur in 'et areas as &ul&a0 glans0 perineum0 under
!reast & a$illa.
#highly inectious lesion
#It is a large raised papule e% a nec/ attached to 1
s/in or mucocutaneous unction.
# ormed o central core o C.2. co&ered !y
hyperplastic acanthotic epithelium.
''-Mucus m$ lesions: a!Leuo#laia : #3ucous
'hite patches in 1 !uccal ca&ity
#round0 o&al or /idney shaped 'hite shinning
$!Snail trac ulcer due to destruction o 1 co&ering
epithelium.
c!Catarrhal in(lammation of respiratory&mucous mb
3ass in 1ry stage o .4
-). 'ee/s .
o:Single .
!ite: a)genital organs .
b) *$tra genital as lip0 tongue0
nipple or ingers .
Size:small(.5)1cm)
"!
Shape: o&al(!utton)li/e) .
'ain: painless$ o brady(ini n )
Colour:pale !ro'nish red
"%
Consistency:hard(indurated)
# its center is ulcerated producing
an ulcer * sore ch% !y ):
Sha#e :o&oid .
Margin : irregular .
Edge : sharp .
Base :Indurated ..
Floor :clear & co&ered e% crust .
Draining L.Ns: "u!!ery (shotty) 0
enlarged0 hard0
painless .
# 2he ulceration is e$tensi&e in 1
1 - &ef +
" -
,ime :
- - ./ +
1-0e# o. of spirochetes !o
6ess Or non inectious.
"-%entral caseation:)
#e% preser&ation o outline as no li7ueaction
#appear acidophilic structureless granular
3aterial.
-- 1 reaction (as before) the only 1
st
5
statements as no 6.(s aection. )*+,
8ealing e% extensive fibrosis the
aected organ is shrun/en e% loss o
architecture.
'''-Lym#h nodes lesions&
#generalized moderate lymphadenitis.
#6.(s: "u!!ery0 enlarged0irm0 painless.
'%-"((ection o( internal organs.
%-general sym#toms: e&er)headache)malase.
1- 1 reaction (as before). )*+,
"- ,he reaction may be in hair follicles or around it.
!ame
mucous mem!rane
1 - large o. of spirochetes !o
higly inectious .
" - 2ild necrosis 3 neutrophils .
-- 1 reaction $as before). )*+,
8ealing e% small scar
4 - 2./ +
5 - 0ate +