Mw W.Z. 1984

• Poli dermatologie• Roodheid coeur; wisselend aanwezig,

erytheem + papels• Tevens sinds 1 jaar haarverlies eci;

bij wassen vele haren los, wil pruik

• Lues screening POS• Blot POS• RPR 1:256

Lues screening +

• Lues

• Endemische treponematose

• Aspecifiek

• Lyme?

The Endemic Treopnematosis; Clinical Microbiology Reviews, 2014

Stadia

• Primaire lues (incubatie 9-90 dagen), duurt 3 weken

• Secundaire luesontstaat na 2 maanden en duurt tot 4 jaar

• Latente luesduurt 5-50 jaar

• Tertiaire lues

Lues 2• Jeukt niet• Symmetrisch• Koper rood• 8 weken maculae• 12 weken papels

Syphilitic alopecia• Patchy hair loss is characteristic of

syphilis• The hair falls leaving small, scattered,

irregularly thinned, ‘motheaten’ patches of semi-baldness. The eyebrows and beard may be affected Syphilitic alopecia may be accompanied by a more generalized, diffuse alopecia associated with generalized infection and anaemia

Behandeling

• 2,4 miljoen IE penicilline imvroeg: eenmaliglaat: dag 1-8-15

• Doxycycline 2 dd 100mgvroeg: 2 wekenlaat: 4 weken

• Zwangere: azithromycine• RPR / VDRL vervolgen

http://www.google.nl/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&docid=wbBiCXKfRliWfM&tbnid=vH529La6VP8pzM:&ved=0CAUQjRw&url=http://www.quickmeme.com/Forever-Alone/page/189/&ei=yovWUqTaHcPP0AX714DADg&psig=AFQjCNGn9oQETfnz8n9w6W0tQ6okI2l49w&ust=1389878469074601

The limerick of syphilis• There was a young man of Black Bay,

Who thought syphilis just went away,And felt that a chancre,Was merely a canker,Acquired in lascivious play.

• Now first he got acne vulgaris,The kind that is rampant in Paris,It covered his skin,From forehead to shin,And now people ask where his hair is.

• With symptoms increasing in number,His aorta’s in need of a plumber,His heart is cavorting,His wife is aborting,And now he’s acquired a gumma.

• Consider his terrible plight,His eyes won’t react to the light,His hands are apraxicHis gait is ataxic,He’s developing gun-barrell sight.

• His passions are strong, as before,But his penis is flaccid, and sore,His wife now has tabesAnd sabre-shinned babies,She’s really worse off than a whore.

• There are pains in his belly and knees,His sphincters have gone by degrees,Paroxysmal incontinence,With all its concomitants,Brings on quite unpredictable pees.

• Though treated in every known way,His spirochetes grow day by day,He’s developed paresis,Converses with Jesus,And thinks he’s the Queen of the May.