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Dermatology
Sexually Transmitted Infections
Built from Dermatology, 5th Edition
What’s inside
12 sections · 146 slides
Overview
- Terminology: STD versus STI
- Scale of the problem
- Sexually transmitted and transmissible pathogens
- Sexually transmitted and transmissible pathogens (continued)
Syphilis: History and Epidemiology
Treponema pallidum infection: origins, natural history, and modern trends
- Syphilis: key features
- Where the name "syphilis" comes from
- Natural history: the Oslo and Tuskegee studies
- Natural history of untreated syphilis
- Global and US trends
- Reported rates of primary and secondary syphilis in the US, by sex
- Who is most affected
Biology and Pathogenesis of T. pallidum
The organism, how it spreads through the body, and its four disease stages
- Classification of Treponema species
- Disease
- (continued)
- The organism: Treponema pallidum
- Characteristic features of Treponema pallidum
- Darkfield examination showing Treponema pallidum
- Four stages of untreated syphilis
- Evolution of untreated syphilis
- Primary stage: what happens locally
- Secondary stage: how it spreads
- Latency and the tertiary stage
- Syphilis increases the risk of catching HIV
Primary Syphilis
The chancre: presentation and laboratory confirmation
- The chancre
- Chancres of primary syphilis at different sites
- Confirming primary syphilis in the lab
Secondary Syphilis
The "great imitator": widespread skin, mucosal, and systemic disease
- Clinical manifestations of syphilis
- How secondary syphilis begins
- Cutaneous features of secondary syphilis
- Clinical features of secondary syphilis
- Secondary syphilis: cutaneous presentations
- Mucosal and moist-area lesions
- Orogenital lesions of secondary syphilis
- Less common presentations
- Less common manifestations of secondary syphilis
- Secondary syphilis: palms and soles
- Secondary syphilis: widespread papular exanthem
- Secondary syphilis: subtle facial lesions
- Course and relapse
- Confirming secondary syphilis in the lab
- Work-up once secondary syphilis is diagnosed
Latent and Tertiary Syphilis
The silent period, and the late complications that can follow it
- Latent syphilis: early versus late
- What happens if latent syphilis goes untreated
- Tertiary (late) syphilis: overview
- Clinical manifestations of late syphilis
- "Benign" late syphilis: gummas
- Cutaneous gummas of tertiary syphilis
- Cardiovascular syphilis
- Neurosyphilis: an infection that can occur at any stage
- Classification of neurosyphilis
- Forms of symptomatic neurosyphilis
- Neurosyphilis in HIV-positive patients
- Confirming neurosyphilis in the lab
Congenital Syphilis
Mother-to-child transmission, presentation, and long-term stigmata
- Congenital syphilis: background
- Mother-to-child transmission of untreated syphilis and its consequences
- Early congenital syphilis
- Time course of clinical manifestations of congenital syphilis
- Congenital syphilis: plantar skin plaques
- Late congenital syphilis: the stigmata
- Stigmata of congenital syphilis
- Stigmata of congenital syphilis (continued)
- Diagnosing congenital syphilis
Laboratory Diagnosis and Treatment of Syphilis
Non-treponemal and treponemal tests, histology, and penicillin-based therapy
- Two families of blood tests
- Specific and nonspecific serologic tests for syphilis over time
- Limitations of non-treponemal and treponemal tests
- Direct detection of the organism
- Skin biopsy findings by stage
- Histology of secondary syphilis
- Differential diagnoses for syphilis
- Differential diagnoses for syphilis (continued)
- Treatment: penicillin is still first-line
- Treatment recommendations for syphilis
- Treatment recommendations for syphilis (continued)
- Treatment in pregnancy and the newborn
- Treatment recommendations for syphilis in special situations
- Monitoring the response to treatment
Gonorrhea
Neisseria gonorrhoeae: from urethritis to disseminated infection
- Gonorrhea: key features
- A brief history
- The resistance problem
- Epidemiology of gonorrhea
- How gonorrhea spreads
- Biology of N. gonorrhoeae
- How gonorrhea causes disease
- Clinical manifestations of gonorrhea
- Gonorrhea: how common are symptoms
- Gonococcal infection in men
- Gonococcal urethritis with purulent discharge
- Gonococcal infection in women
- Extragenital gonorrhea
- Gonococcal eye infection
- Disseminated gonococcal infection
- Gonococcemia: pustule on the toe
- Gonococcemia: hemorrhagic skin lesion
- Diagnostic algorithm for urethral discharge or dysuria
- Staining and culture for diagnosis
- Gonococci in Gram-stained and methylene blue-stained smears
- Molecular (NAAT) testing
- Pathology and differential diagnosis
- Treatment recommendations for gonococcal infections
- Treatment recommendations for gonococcal infections (continued)
- Treatment of gonorrhea today
Chancroid
Haemophilus ducreyi: a painful, purulent genital ulcer disease
- Chancroid: key features
- History and epidemiology
- Estimated worldwide prevalence of chancroid
- Infectious causes of genital ulcer disease
- Infectious causes of genital ulcer disease (continued)
- Transmission and HIV risk
- Biology and how the disease develops
- Gram-stained smear in chancroid showing chaining bacteria
- Clinical presentation
- Chancroid: genital ulcers and inguinal lymphadenitis
- Diagnosis and differential diagnosis
- Treatment regimens for chancroid
- Treating chancroid
Lymphogranuloma Venereum
Chlamydia trachomatis serovars L1-L3: a three-stage lymphatic disease
- LGV: key features
- History and epidemiology
- Pathogenesis
- Clinical manifestations of lymphogranuloma venereum
- Stage one: the primary lesion
- Stage two: the inguinal syndrome
- Lymphogranuloma venereum: ruptured, draining inguinal bubo
- Stage three: ano-genito-rectal syndrome
- Diagnosis and differential diagnosis
- Treatment regimens for lymphogranuloma venereum
- Treating LGV
Donovanosis (Granuloma Inguinale)
Klebsiella granulomatis: a rare, slowly progressive ulcerative infection
- Donovanosis: key features
- History and epidemiology
- Worldwide distribution of donovanosis
- Pathogenesis
- Clinical presentation
- Donovanosis: beefy-red genital ulcer
- Diagnosis and differential diagnosis
- Treatment regimens for donovanosis
- Treating donovanosis
- Comparing the five classic STIs
- Key take-home points
- References
- References (continued)
- References (continued)
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- References (continued)
- References (continued)
- Dermatology, 5th Edition (2-Volume Set)