How to determine if you have syphilis

Written by Huang Ling Juan
Dermatology
Updated on December 31, 2024
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To determine if one has syphilis, initial assessments should integrate clinical symptoms, including the presence of a chancre and syphilis rash. Subsequently, it is advised to visit an accredited hospital to undergo serological testing for syphilis, which involves the detection of both specific and non-specific antibodies of syphilis. A comprehensive evaluation of these findings can assist in diagnosing whether one is infected with syphilis. Once syphilis is confirmed, it is crucial to commence systematic and standardized treatment promptly. Generally, if both the syphilis-specific antibody test and the non-heated treponemal pallidum particle agglutination test are positive, these indicate an active syphilis infection. Treatment should be sought at a reputable medical facility, promptly utilizing penicillin for standardized treatment. If there is an allergy to penicillin, tetracycline antibiotics can be considered as an alternative.

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Written by Zhu Zhu
Dermatology
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Early symptoms of syphilis

Syphilis is a sexually transmitted disease caused by the bacterium Treponema pallidum, with the disease course within two years referred to as early syphilis. Not all infected individuals display symptoms; asymptomatic syphilis is also known as latent syphilis. Symptomatic early syphilis primarily manifests as either primary or secondary syphilis. The main symptom of primary syphilis is a chancre, typically occurring as a clear-bordered ulcer in the genital area. It is flesh-colored and neither painful nor itchy. Several weeks after the chancre heals, secondary syphilis can develop, characterized by a rash that may resemble other skin conditions. Common manifestations include macules, papular macules, copper-red papules on hands and feet, flat condyloma, and syphilitic alopecia. Individuals who suspect they may have been exposed to syphilis should visit a hospital for a blood test to detect syphilis antibodies. Antibodies can usually be detected four weeks after infection, and a negative result three months later can rule out syphilis.

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Written by Zhu Zhu
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How long does it take to cure third-stage syphilis?

The healing time for third-stage syphilis varies from person to person. Third-stage syphilis is considered a late stage of the disease, and the situation is very serious for patients who have developed to this stage. Therefore, the duration of illness for most patients is usually very long; it could be several months or even years, which also depends on the patient's level of aggressive treatment and their own immune resistance. Additionally, it is necessary to consider complications of third-stage syphilis. If there are severe complications involving cardiovascular and nervous systems, or joint damage, recovery can be very prolonged and difficult.

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Written by Zhu Zhu
Dermatology
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Can third-stage syphilis still be cured?

Third-stage syphilis can still possibly be cured, but this varies from person to person and is not absolute. Usually, when syphilis develops to the third stage, it indicates a more severe infection and is considered late-stage. Additionally, third-stage syphilis is particularly prone to causing cardiovascular, neurological, and musculoskeletal damages, which are complications. Therefore, treating third-stage syphilis is much more challenging compared to the first and second stages. It is crucial to treat and diagnose it early.

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Written by Cui Lin Jing
Dermatology
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What are the symptoms of tertiary syphilis?

Tertiary syphilis mainly occurs two to three years, or even five to ten years or longer, after infection. The primary skin manifestations are gummas, which often occur on the extensor side of the lower legs, and can present as ulcerations, erosions, nodules, and hyperplasia. It may also involve bones, joints, the heart, and blood vessels. The main manifestations include aortitis, aortic valve insufficiency, and aortic aneurysms. When the nervous system is involved, it can present as spinal tuberculosis and general paralysis, which are symptoms of paralytic dementia. The diagnosis of tertiary syphilis requires serological tests and cerebrospinal fluid analysis. The treatment involves primarily penicillin and benzathine penicillin, with erythromycin or tetracycline as alternatives for patients allergic to penicillin, and requires a longer course of treatment.

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Can syphilis antibodies be detected during the hard chancre stage?

During the hard chancre phase of syphilis, a portion of cases can test positive for Treponema pallidum, although some tests may return negative results. In such cases, it is advisable to retest after one month. The earliest detectable antibodies for Treponema pallidum are usually of two types: a Treponema pallidum-specific antibody, which appears earlier than the non-specific antibodies. There are tests for non-specific antibodies, commonly referred to as RPR or TRUST, which are standard practices in major hospitals. Therefore, in early-stage syphilis or primary syphilis with hard chancre, it is possible to find Treponema pallidum-specific antibodies positive, RPR or TRUST negative, or both negative. If syphilis is strongly suspected in such cases, a retest is recommended after one month.