III stage of syphilis
Single large knots up to the size of a walnut or even a chicken egg (gum) and smaller ones (tubercles), usually located in groups, appear on the skin. Gumma gradually grows, the skin becomes bluish-red, then a viscous fluid begins to stand out from its center and a long-healing ulcer with a characteristic yellowish bottom of a "greasy" appearance forms. Gummy ulcers are characterized by a long existence, lasting for many months and even years. Scars after their healing remain for life, and according to their typical stellate appearance, it can be understood after a long time that this person had syphilis. Tubercles and gummas are most often located on the skin of the anterior surface of the legs, in the region of the shoulder blades, forearms, etc. One of the common places of tertiary lesions is the mucous membrane of the soft and hard palate. Ulcerations here can reach the bone and destroy bone tissue, soft palate, wrinkle with scars, or form holes leading from the oral cavity to the nose, which makes the voice typical nasal. If gummas are located on the face, then they can destroy the bones of the nose, and it "fails."
At all stages of syphilis, internal organs and the nervous system can be affected. In the early years of the disease, some patients have syphilitic hepatitis (liver damage) and manifestations of "latent" meningitis. With treatment, they pass quickly. Much less frequently, after 5 or more years, these organs sometimes form seals or gum, similar to those that appear on the skin.
Most often, the aorta and the heart are affected. Syphilitic aortic aneurysm is formed; in some part of this vessel, which is most important for life, its diameter expands sharply, and a bag with strongly thinned walls (aneurysm) is formed. Aneurysm rupture leads to instant death. The pathological process can also "slide" from the aorta to the mouths of the coronary vessels that feed the heart muscle, and then angina attacks occur, which are not removed by commonly used means. In some cases, syphilis causes myocardial infarction. Already in the early stages of the disease, syphilitic meningitis, meningoencephalitis, a sharp increase in intracranial pressure, strokes with full or partial paralysis, etc. can develop. These severe events are very rare and, fortunately, respond well enough to treatment.
Late lesions (spinal cord, progressive paralysis). Occur if a person has not been treated or was treated poorly. With spinal cord, pale treponema affects the spinal cord. Patients suffer from bouts of acute excruciating pain. Their skin loses its sensitivity so much that they may not feel a burn and pay attention only to skin damage. The gait changes, it becomes a "duck", at first difficulty urinating, and then incontinence of urine and feces. The damage to the optic nerves is especially difficult, leading to blindness in a short time. Rough deformations of large joints, especially knee joints, can develop. There are changes in the size and shape of the pupils and their reaction to light, as well as a decrease or complete disappearance of tendon reflexes, which are caused by a blow of the hammer on the tendon below the knee (knee reflex) and above the heel (Achilles reflex).
Progressive paralysis usually develops after 15-20 years. This is an irreversible brain damage. Human behavior dramatically changes: disability decreases, mood fluctuates, self-criticism decreases, either irritability, explosiveness appear, or, conversely, unreasonable gaiety, carelessness. The patient does not sleep well, his head often hurts, his hands tremble, his face muscles twitch. After some time, it becomes tactless, rude, lustful, discovers a tendency to cynical abuse, gluttony. His mental abilities fade away, he loses his memory, especially for recent events, the ability to correctly count with simple arithmetic operations "in the mind", when writing misses or repeats letters, syllables, the handwriting becomes uneven, messy, speech slow, monotonous, as if " stumbling. " If treatment is not carried out, then it completely loses interest in the world around it, soon refuses to leave the bed, and in cases of general paralysis, death occurs. Sometimes with progressive paralysis, delusions of grandeur, sudden bouts of agitation, aggression, dangerous to others.