Mucous membranes of the mouth, nose, throat and larynx is often affected in Tertiary syphilis. The reason is, presumably, the fact that these regions are exposed constantly irritation, and often there are inflammatory processes. All this leads to local weakening of the resistance of tissues.
On the mucous membranes of the gummy syphilis can manifest itself in the form of rashes and Bugorkova gummas. More often observed deep gummy lesions; papulose syphiloderm occurs less frequently.
- Gunma lips lips characterized by the development of infiltration is not ostrovospalitelnogo type plotnovata touch. If timely treatment is not taken, the infiltration of the gummy undergoes necrosis and ulceration; thereby forming a deep ulcer with a necrotic core and infiltrated edges.
- When the differential diagnosis of ulceration in the stage should be kept in mind cancerous ulcer. It should consider the following: 1) the duration of the existence of gummy ulcers less than cancerous sores; 2) gummy edge ulcers steep, dense; a cancerous ulcer – solid, callous; regional lymph nodes with gummy ulcer is usually not increased; in cancer – increased, dense consistency; 4) serological response in the first case can be positive in the second – negative. However, it should be remembered that weak positive serological reactions may be cancer.
- Gummy tongue lesions are found in the form of: 1) nodular glossitis and 2) diffuse sclerosing glossitis.
1. Knotty glossitis. It appears solid consistency node laid in the thickness of the tongue muscles. When opened Gunma, formed ulcer due to additional stimuli when eating may lose specific features inherent gummy ulcer.
In the differential diagnosis should be borne in mind cancer and tuberculosis, and should take into account the symptoms characteristic of gummy mouth ulcer.
Differentiation of tuberculous ulcers should be considered: 1) the softness of the edges of tubercular ulcers; 2) pronounced pain; 3) the presence of active TB in the lungs or larynx.
2. Diffuse sclerosing glossitis is characterized by the seal of language, its increase. Patients complain that the language does not fit in your mouth. Its surface is irregular, folded, resembles a “scrotal” language. Histopathological when this species is observed diffuse glossitis gummy infiltration of the submucosa and muscles of the tongue and the proliferation of fibrous tissue, which gives the density of the body.
Gummy defeat sky are quite common. In the area of the soft palate are observed both papulose syphiloderm and gumma. Gummy lesions of the hard palate may occur if the primary site gumma at the site or as a result of irradiation of gummy process by the nasal cavities.
Bugorkova syphiloderm mucosal ulceration is exposed to the sky quickly. When establishing the diagnosis of tuberculosis should be remembered ulcerations which on oral mucosa may be in the form or ulcerative tuberculosis (tuberculosis ulcerosa propria), or in the form of lupus.
The first type is characterized by painful ulcers with isolated podrytymi edges and usually seen in patients with active pulmonary tuberculosis or larynx, the second is often associated with lupus skin, nose.
Sky Gunma occur much more frequently than papulose syphiloderm. Not recognized in a timely manner, they lead to significant destruction of hard and soft palate, with scarring that major defects remain. For example, the localization of gumma in the hard palate is often a defect in the shape of an oval opening between the mouth and the nose, which greatly complicates the reception of liquid food: it is poured through the nose.
With the localization of gummy diffuse infiltration in the soft palate often occurs palatal complete destruction of the curtains and the solid part of the sky, followed by scar deformity. As in the first and in the second case it is significantly impaired phonology – it becomes nasal, muffled.