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Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii
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vol. 36
Letter to the Editor

Syphilis and a pregnant woman: a real danger for the woman and the child

Katarzyna Plagens-Rotman, Renata Przybylska, Katarzyna Gerke, Małgorzata Piskorz-Szymendera, Magdalena Tomaszewska, Anna Sadowska-Przytocka, Zygmunt Adamski, Magdalena Czarnecka-Operacz

Adv Dermatol Allergol 2019; XXXVI (1): 119-124
Online publish date: 2019/02/22
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Syphilis is one of the sexually transmitted infections (STI) caused by Treponema pallidum of the Spirochaetaceae family, which is a Gram-negative bacterium measuring between 10–13 µm and 0.15 µm in diameter. Their characteristic feature is a rotational, forward and twisting movement observed in the macroanalysis. What is more, they are sensitive to dryness, high temperature, and antiseptics. Infection with Treponema pallidum is caused by the bacteria passing through the damaged mucous membrane, soft tissue mucosa, as well as directly getting into the bloodstream. The most common route of infection is a sexual intercourse, both oral and rectal [1–3]. Crucially, a transmission of the infection from the infected woman to the foetus is possible.
The World Health Organization (WHO) estimates that every year 1.5 million pregnant women are diagnosed with Treponema infections, whereas 520 000 present complications, such as intrauterine foetal death, low birth weight, and congenital syphilis in neonates [4]. In Poland, in 2011, syphilis was diagnosed in 13 women during pregnancy and delivery. In comparison, positive serum reactions were observed in 22 pregnant women [5].
The International Union against Sexually Transmitted Infections recommends syphilis screening tests in all pregnant women during the first prenatal appointment [6]. However, in Poland it is obligatory to perform the tests up to the 10 weeks of gestation, and between 33–37th week in the high-risk patient group [7]. Syphilis includes a wide range of clinical symptoms, and is characterized by a long-term and multi-stage course. In general, there are two types of syphilis: acquired (Latin: lues acquisita) and congenital (Latin: lues congenita).
Primary syphilis (Latin: lues primaria) – 3–9 weeks – a painless, single, round or oval primary lesion appears in the area where Treponema pallidum entered the organism. It is characterized by smooth edges and a cartilaginous base. Additionally, the enlargement of the surrounding lymph nodes appears. The most common site of primary lesions in women is the labia, cervix uteri, vaginal mucosa, or the genital area. However, atypical sites include the vermilion border of the lips, buccal mucosa, the tongue and the tonsils [2, 8, 9].
Secondary syphilis (Latin: lues secundaria) – 9 weeks until the end of the 2nd year following the initial infection – is characterized by the appearance of skin and mucosal...

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