,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