Ironically, the most severe infectious diseases are named after the goddess of love, Venus. A rather romantic name was also given to one of the manifestations of dangerous syphilis – the necklace of Venus. This is a skin reaction on the face, neck and chest of the patient, giving it an unaesthetic appearance and requiring serious medical treatment.
What it is?
This is a skin reaction to the presence in the body of the causative agent of Lewis – treponema pale. It is expressed in small pigment spots covering the upper part of the body, in rare cases – its central section.
This symptom appears a few months after the infection enters the body and in medicine it has a less romantic name: syphilitic leukoderma. This name was given to him by the German infectious disease specialist A. Neisser at the end of the nineteenth century, but the first descriptions of this symptom are more ancient, and his Latin name is more familiar to the ears of even modern venereologists.
Leukoderma has two more literary names: “Venus crown” or “Venus belt”.
In addition to the spots covering the body of men and women in the décolleté and neck, the signs of syphilis are also similar symptoms that spread throughout the body, baldness (focal or diffuse), syphilitic ulcers.
All these symptoms are part of the legend about the curse of the goddess Venus to the earthly youth, who decided to avenge his betrayal with gifts: a red shirt, a hat and a pearl necklace, which turned into the main signs of the disease.
What does leukoderma look like?
These manifestations of the disease are very characteristic and visible to the naked eye, they are clearly visible even in amateur photographs taken with a conventional camera. They can look like large whitish spots, the shape is correct – round or oval.
They do not protrude above the epidermis, they do not cause allergic reactions, such as pain when touched, itching, burning, an increase in local temperature or redness.
There is a clear sign of the imminent appearance of the Venus necklace: a few days before the spots appear, the skin changes its color. The shades are different – from pale yellow to dark red, brown. The formations themselves are white, due to which a light lace pattern is formed on the pigmented, most often dark area of the body.
In syphilis, the spots tend to coalesce, whereby the part of the body they cover sometimes resembles the pattern of a giraffe’s skin.
Each patient has a different intensity of manifestation of syphilis pigmentation. Most noticeable is the light rim on a dark body, but with pallor of the skin, the manifestations are almost indistinguishable. In this case, from afar, the necklace can be taken for stains of dirt that appear after an unsuccessful shower or in hot weather after a person has sweated a lot.
The sizes of the spots also vary, but they never exceed fifteen millimeters in diameter. A false idea of \u200b\u200bvalue arises from their tendency to merge: areas are formed that are easy to mistake for one large formation. From whether there is a tendency to merge, leukoderma is divided into:
- spotted (separate spots);
- mesh (with partial merging);
- marble (solid formation).
Main places of manifestation
The favorite areas of the body of this phenomenon are the décolleté and neck areas. Also, signs of the disease may affect:
- upper back;
- lumbosacral region.
In very rare cases, which are recorded in medical reference books, the cheeks and forehead of the patient, arms and legs, including the palms and feet, were affected by the crown of Venus. Before attributing these lesions to signs of syphilis, they should be carefully analyzed, because. such phenomena are more characteristic of skin pathologies: various types of lichen, psoriasis, eczema, atrophic skin phenomena after scars, etc.
Reasons for development
Venus belt is a typical sign of secondary syphilis. By this time, severe damage to the internal organs begins, and the nervous system is one of the first to be hit.
Atrophy of nerve endings leads to a decrease in the sensitivity of the epidermis, disruption of metabolic processes in it, and nutritional deficiencies. This is a direct way to change the pigment composition of the skin layers, which is expressed in the appearance of white spots (pigment deficiency) in individual cells and its excessive accumulation by others.
This reason is also confirmed by laboratory studies: in the analyzes that study these spots, there is no causative agent of Lewis – the bacterium itself, while papular eruptions , roseola and chancre contain pale treponema in excess. The only mystery, even for modern scientists, remains the fundamental location of the necklace of Venus on the neck.
The timing of the rash
Leukopathy appears no earlier than six months after the moment of infection. It is during this period that the beginning of the secondary Lewis period occurs , usually having four stages:
- incubation: proceeds without symptoms, lasts an average of about a month;
- primary: characterized by the formation of a hard chancre, the average period is one and a half to two months;
- secondary: manifested by a variety of syphilitic rash, lasts 2-4 years. A characteristic sign is a change in periods of remission and exacerbations, during which rashes occur, last for several weeks and disappear without any treatment. The remission period lasts from three to five months;
- tertiary: terminal, destructive stage. The main signs are gummas that affect extensive external areas of the body and internal organs. Destruction occurs from parts of the body, nose, ears to the skeleton, teeth. If medical assistance is not provided, vital systems cease to function, and the person dies.
The Venus necklace usually appears at the beginning of secondary syphilis, with the first wave of skin rashes. In the same period, alopecia begins to develop and the first serious malfunctions in the work of the internal systems of the body.
Features of the course of leukoderma
Unlike other types of rash, which disappear after a few months, the crown of Venus remains on the patient’s body for a very long time, sometimes for years. Often such a belt is the only manifestation of syphilis, which is even in stable remission.
In the fairer sex, this phenomenon is diagnosed several times more often than in men, and this sexual preference is also a mystery to scientists.
It is possible to eliminate the symptom with the help of qualified treatment, but after its disappearance, traces of its presence are present for a couple of months.
Leukopathy should be fought only under the constant supervision of a qualified venereologist. The basis of therapy is antibiotics of the penicillin group and additional local agents. The scheme of taking drugs and their dosage are individual for each patient, because. the main task of their administration is to constantly maintain the required dose of antibiotic in the blood.
Leukoderma therapy involves the administration of potent drugs every three hours for 24 days, so it should be done in a hospital.
Another reason why the treatment of syphilis is carried out under the vigilant supervision of doctors is the presence of other rashes on the patient’s body. They pose a threat to others, because. are the direct source of infection.
Their discharge, getting on the skin or mucous membrane of a healthy person, in 99% of cases leads to infection, therefore, during the treatment of open ulcers, the carrier of the virus is shown quarantine.
In addition to potent drugs, the treatment regimen includes immunomodulatory drugs, vitamin and mineral complexes, special dietary supplements that increase local immunity and the body’s overall ability to resist harmful microorganisms.
If the course is complicated, additional intramuscular administration of antibiotics and special preparations containing heavy metals is indicated. Such drugs have a disinfecting and drying effect, which is very important in the fight against ulcers and erosions on the body.
The patient’s condition is constantly monitored, and if the primary therapy regimen does not give the desired results, it is corrected by changing the drugs and their dosage. Also, the patient is shown a special diet and a complete rejection of bad habits.
Taking medication is also indicated for the sexual partner of a patient with syphilitic leukoderma. At the end of the course of treatment, the patient is shown laboratory control every six months for two years. If Lewis does not exacerbate during this period , the person will be removed from the dispensary register.