Congenital Syphillis, Reccurent Apthae, Behcets and Reiter's Syndrome..
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Congenital syphilis occurs when a child is born to a mother with secondary syphilis. If a pregnant mother with syphilis is treated, especially before 16 weeks of pregnancy, it can effectively prevent congenital syphilis in the unborn child. Congenital syphilis can result in stillbirth, symptoms in the newborn like bone and teeth abnormalities, or a normal child. Recurrent aphthous stomatitis, or canker sores, are small ulcers that repeatedly form in the mouth and are thought to have multiple contributing factors including genetics, immunity, nutrition, trauma, and systemic disease. Beh巽et's syndrome is characterized by recurrent oral and genital ulcers along with
Congenital Syphillis, Reccurent Apthae, Behcets and Reiter's Syndrome..
- 3. Congenital syphilis is syphilis present in utero and at birth, and occurs when a child is born to a mother with secondary syphilis If a pregnant mother is identified as being infected with syphilis, treatment can effectively prevent congenital syphilis from developing in the unborn child, especially if she is treated before the sixteenth week of pregnancy Result in Still birth / congenital syphilis / normal child
- 4. Frontal bossing and short maxilla
- 5. High arch palate and mulberry/moon molar
- 6. Saddle nose Higoumenakis Sign
- 7. Rhagades Shaber shin
- 9. Treatment A woman in the secondary stage of syphilis decreases her child's risk of developing congenital syphilis by 98% if she receives treatment before the last month of pregnancy. An affected child can be treated using antibiotics much like an adult; however, any developmental symptoms are likely to be permanent
- 10. Recurrent Aphthous stomatitis also termed canker sores, recurrent aphthous stomatitis, RAS, recurring oral aphthae and recurrent aphthous ulceration repeated formation of ulcers in the mouth
- 11. Etiology The cause is not entirely clear, but is thought to be multifactorial Multiple research studies have attempted to identify a causative organism Genetic History Immunology Iron, Vitamin B, Folic Acid deficiency
- 12. Precipitating Factors Trauma Endocrine Factors Psychic Factors Allergic Factors Systemic Disease
- 13. Classification Recurrent Aphthous minor Recurrent Aphthous major Recurrent Herpetiform ulceration Associated with Behcets syndrome
- 14. Clinical Features , Mikulicz ulcers They occur mainly in persons 10-40 years of age. They often cause pain and inability to eat . They are small round or ovoid ulcers 2-4 mm in diameter Ulcer floor that is yellowish but assumes a gray hue. Surrounded by an erythematous halo and some edema. They are found mainly on the nonkeratinized mobile mucosa. They occur in groups of only a few ulcers (ie, 1-6) at a time. They heal in 7-10 days. They leave little or no evidence of scarring.
- 16. Sutton ulcers They are larger, of longer duration, of more frequent recurrence, and often more painful. They are round or ovoid like MiAUs but are larger They reach a large size, usually about 1 cm or more They are found on any area of the oral mucosa They occur in groups of only a few ulcers (ie, 1-6) They heal slowly over 10-40 days. They recur extremely frequently. They may heal with scarring.
- 18. Herpetiform ulceration (HU) They are found in a slightly older age group, in females They begins with vesiculation that passes rapidly into multiple, minute, pinhead-sized, discrete ulcers. They involve any oral site, including the keratinized mucosa, increase in size, and coalesce to leave large round ragged ulcers. They heal in 10 days or longer. They are often extremely painful. They recur so frequently that ulceration may be virtually continuous.
- 20. Histologic Features... Ulceration Fibrinopurulent membrane Micro organism Granulation tissue Inflammation Endothelial cells Fibrosis
- 22. Anitshow cell
- 23. Treatment Modalities Antibiotics Antiseptics Diet Suppliment Symptomatic Treatment
- 24. Beh巽et's syndrome Turkish dermatologist Hulusi Beh巽et, 1937 a syndrome of recurrent aphthous ulcers, genital ulcerations, and uveitis leading to blindness. Etiology is proposed to be an infectious trigger, with inflammatory mediators and immune deregulation HLA B 51 Environmental Factors Infections
- 25. In 1990, the International Study Group (ISG) for Beh巽et's Disease clarified criteria for the diagnosis of Beh巽et disease Recurrent painful genital ulcers that heal with scarring Ophthalmic lesions, including anterior or posterior uveitis, hypopyon, or retinal vasculitis Skin lesions, including erythema nodosumlike lesions, pseudofolliculitis, or papulopustular or acneiform lesions
- 27. Oral Lesions Painful oral lesions (aphthous or herpetiform) high recurrence rate multiple lesions or crops commonly found in keratinized areas
- 28. Skin lesions lesions often occur in the genital region of both sexes In males, scrotal, penile shaft. In females, the labial area, vagina and on the perineum Acneiform papulopustular lesions
- 29. Ocular Lesions anterior or posterior uveitis, hypopyon Symptoms commonly include blurred vision, periorbital pain, photophobia, and excessive lacrimation. Highly recurrent posterior uveitis can lead to blindness.
- 30. Lab Findings Hypergammaglobulinemia Leukocytosis with eosinophilia CRP, C9, C3 and C4 may be elevated
- 31. Treatment No specific treatment May spontaneously resolve or lead to death
- 32. Reiters Syndrome characterized by a triad of balanitis, urethritis, and conjunctivitis, and by lesions of the skin and mucosal surfaces. Infectious origin ?? Mimics Gonorrhea Considered to be an immunodysregulated condition HLA B27
- 33. Urethritis is a common condition of Reiter's. This involves inflammation of the urethra Arthritis - experience swelling and tenderness conjunctivitis may develop. Skin lesions appear as small, painless sores on the head of the penis, roof of the mouth or tongue.
- 36. Treatment May undergo spontaneous remission Can be treated by antibiotics and corticosteroids...
- 41. Thank you...