{"id":204,"date":"2025-08-02T06:10:43","date_gmt":"2025-08-02T06:10:43","guid":{"rendered":"https:\/\/dermacab.net\/?page_id=204"},"modified":"2025-08-02T20:55:02","modified_gmt":"2025-08-02T20:55:02","slug":"syphilis-tertiaire-forme-gommateuse","status":"publish","type":"page","link":"https:\/\/dermacab.net\/index.php\/dermatologie\/maladies-des-cheveux-et-du-cuir-chevelu\/alopecies-non-cicatricielles\/syphilis-tertiaire-forme-gommateuse\/","title":{"rendered":"\ud83e\uddeb Syphilis tertiaire (forme gommateuse)"},"content":{"rendered":"\n<h2 class=\"wp-block-heading\">\ud83e\uddec D\u00e9finition<\/h2>\n\n\n\n<p>La syphilis tertiaire est le stade tardif et chronique de l\u2019infection \u00e0 <em>Treponema pallidum<\/em>, pouvant survenir <strong>plusieurs ann\u00e9es apr\u00e8s l\u2019infection primaire<\/strong> en l\u2019absence de traitement. La <strong>forme gommateuse<\/strong> correspond \u00e0 des l\u00e9sions granulomateuses destructrices affectant la <strong>peau<\/strong>, les <strong>os<\/strong> ou les <strong>organes internes<\/strong>.<\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h3 class=\"wp-block-heading\">\ud83d\udd52 D\u00e9lai d\u2019apparition<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>En g\u00e9n\u00e9ral <strong>10 \u00e0 30 ans<\/strong> apr\u00e8s la primo-infection<\/li>\n\n\n\n<li>Rare depuis l\u2019\u00e8re des antibiotiques, mais toujours possible chez les sujets <strong>non ou mal trait\u00e9s<\/strong><\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h3 class=\"wp-block-heading\">\ud83d\udd0d Pr\u00e9sentation clinique<\/h3>\n\n\n\n<h4 class=\"wp-block-heading\">Formes cutan\u00e9es (gommes dermiques)<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Nodules indolents<\/strong> \u00e9voluant vers une <strong>ulc\u00e9ration centrale<\/strong><\/li>\n\n\n\n<li><strong>Contour polycyclique<\/strong>, bord sur\u00e9lev\u00e9, fond n\u00e9crotique<\/li>\n\n\n\n<li>Localisation : <strong>visage<\/strong>, tronc, membres, parfois <strong>cuir chevelu<\/strong> (alop\u00e9cie cicatricielle possible)<\/li>\n\n\n\n<li>Cicatrisation lente, laissant une <strong>cicatrice atrophique<\/strong><\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Autres localisations possibles :<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Os<\/strong> : douleurs nocturnes, ost\u00e9ites, l\u00e9sions lytique sur imagerie<\/li>\n\n\n\n<li><strong>Organes internes<\/strong> : foie, testicules, larynx, etc.<\/li>\n\n\n\n<li><strong>Syst\u00e8me nerveux central<\/strong> : neurosyphilis tertiaire (par\u00e9sie, tab\u00e8s dorsalis)<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h3 class=\"wp-block-heading\">\ud83e\uddea Diagnostic<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>S\u00e9rologies syphilitiques<\/strong> :\n<ul class=\"wp-block-list\">\n<li>TPHA-VDRL : VDRL souvent n\u00e9gatif \u00e0 ce stade<\/li>\n\n\n\n<li>Test tr\u00e9pon\u00e9mique (TPHA, FTA-abs) toujours positif<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Biopsie<\/strong> (rarement n\u00e9cessaire) : granulome avec cellules \u00e9pith\u00e9lio\u00efdes, plasmocytaires et n\u00e9crose centrale<\/li>\n\n\n\n<li>Imagerie osseuse ou visc\u00e9rale si atteinte profonde<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h3 class=\"wp-block-heading\">\ud83d\udc8a Traitement<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Benzathine p\u00e9nicilline G<\/strong> <\/li>\n\n\n\n<li>En cas d\u2019allergie : doxycycline<\/li>\n\n\n\n<li>Suivi biologique : s\u00e9rologies \u00e0 3, 6, 12 mois<\/li>\n\n\n\n<li>\u00c9valuation clinique des atteintes syst\u00e9miques<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h3 class=\"wp-block-heading\">\ud83d\udd04 Pronostic<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Bonne r\u00e9ponse au traitement si l\u00e9sions limit\u00e9es<\/li>\n\n\n\n<li>Les <strong>s\u00e9quelles cicatricielles<\/strong> cutan\u00e9es ou osseuses peuvent persister<\/li>\n\n\n\n<li>Risque de complications graves en cas d\u2019atteinte visc\u00e9rale ou neurologique non prise en charge<\/li>\n<\/ul>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<h3 class=\"wp-block-heading\">\ud83d\udccd Prise en charge au Cabinet du Dr Hadi HAKIM \u2013 Dakar<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Bilan diagnostique complet<\/li>\n\n\n\n<li>Coordination avec infectiologie, neurologie ou imagerie selon l\u2019atteinte<\/li>\n\n\n\n<li>Suivi post-traitement et \u00e9valuation s\u00e9rologique<\/li>\n\n\n\n<li>Conseil aux partenaires, d\u00e9pistage et \u00e9ducation<\/li>\n<\/ul>\n\n\n\n<p>\ud83d\udcde <strong>+221 33 821 31 22<\/strong><br>\ud83d\udcac <strong>WhatsApp professionnel disponible<\/strong><br>\ud83d\udccd <em>Cabinet de Dermatologie et MST \u2013 Dakar<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>\ud83e\uddec D\u00e9finition La syphilis tertiaire est le stade tardif et chronique de l\u2019infection \u00e0 Treponema pallidum, pouvant survenir plusieurs ann\u00e9es apr\u00e8s l\u2019infection primaire en l\u2019absence de traitement. La forme gommateuse correspond \u00e0 des l\u00e9sions granulomateuses destructrices affectant la peau, les os ou les organes internes. \ud83d\udd52 D\u00e9lai d\u2019apparition \ud83d\udd0d Pr\u00e9sentation clinique Formes cutan\u00e9es (gommes dermiques) [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":212,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-204","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/dermacab.net\/index.php\/wp-json\/wp\/v2\/pages\/204","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dermacab.net\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dermacab.net\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dermacab.net\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/dermacab.net\/index.php\/wp-json\/wp\/v2\/comments?post=204"}],"version-history":[{"count":1,"href":"https:\/\/dermacab.net\/index.php\/wp-json\/wp\/v2\/pages\/204\/revisions"}],"predecessor-version":[{"id":205,"href":"https:\/\/dermacab.net\/index.php\/wp-json\/wp\/v2\/pages\/204\/revisions\/205"}],"up":[{"embeddable":true,"href":"https:\/\/dermacab.net\/index.php\/wp-json\/wp\/v2\/pages\/212"}],"wp:attachment":[{"href":"https:\/\/dermacab.net\/index.php\/wp-json\/wp\/v2\/media?parent=204"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}