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May F. Gonzales, M.D.

,FPDS
 Lower GU tract, anorectum, oropharynx
Males – purpultent urethral discharge
Females – asymptomatic
Untreated – Abscess Disseminated infection
 Young, sexually active, newborn
 Neisseria gonorrhea
 Males – within 5 days
 Females - >2 weeks
 Prevention
 Antimicrobial – Ceftriaxone IM, Ciprofloxacin
 Management of sex partners
 Hemophilus ducreyi
 Painful ulcer with erthema and edema
 Management – Azithromycin, Ceftriaxone,
Erythromycin
 Granuloma inguinale / venereum
 Calymma tobacterium granulomatis
Beefy red granulation tissue
 Management – Chloramphenicol, Gentamycin ,
Tetracycline
 Chlamydia trachomatis
 Striking tender lymphadenopathy at the femoral and
inguinal lymph nodes separated by Poupart’s groove
Frei skin test
 Management - Doxycycline
 Human papillomavirus
 Pinhead to cauliflowerlike
 Condylomata acuminata
 Diagnosis – aceto whitening, serology, Pap Smear
 Management – Cryosurgery, Podophyllin,
TCA 80 – 90%, ECT, imiguimod
 Lues
 The great imitator
 Treponema pallidum
 21 days ( 10 – 90 days ) incubation period
 Painless ulcer
 2 – 10 weeks after chancre
Condyloma lata
 Mucous patches
 Syphilids
Papulosquamous eruption on the trunk and palms
 Early latent - < 2 years
 Late latent - > 2 years
 No clinical signs or symptoms
 3 – 7 years
 Gumma
 Nodular , ulcer
 Darkfield examination
 Direct Fluorescent Antibody test
 Serologic tests
A. Non – treponemal – VDRL, RPR
B. Treponemal – FTA – ABS
MHA – TB
 Dermatopathology
 Primary, Secondary and Early latent of less than 1
year
Benzathine Penicillin G2.4m / IM in 1 dose
Alternative – Doxycycline, Tetracycline,
Erythromycin, Ceftriaxone
 Late latent More than 1 year
Benzathine Penicillin G7.2m / IM in 3 dose s 1
week apart
Alternative – Doxycycline, Tetracycline
 15 – 25% population
 Wheals, angioedema
 Abdominal pain, coryza, asthma, respiratiory
problem
 Airway obstruction, hypotension
 Acute - < 6 weeks
 Chronic - > 6 weeks
 Drugs
 Aspirin
 Food
 Food Additives
Infections
 Emotional stress
 Menthol
Neoplasm
 Inhalant
 Viruses
 Parasites
 Alcohol
 Angioedema
 Dermatograhia
 Cholinergic
 Adrenergic
Cold
 Heat
 Solar
 Pressure
 Exercise induced
 Vibratory
 Aquagenic
 Antihistamines
 Cortocosteroids
Acupuncture
 Calcium channel antagonist
 Anti – malarial, papsone, gold, Azathioprine,
Methotrexate
 Terbutaline