Congenital syphilis-clinical features

Swelling of right elbow with restriction of movement- Pseudoparalysis of Parrot 
( Ref: Machiraju et al. Case Reports in Pediatrics Volume 2012)

Swelling of right knee with restriction of movement- Pseudoparalysis of Parrot
( Ref: Machiraju et al. Case Reports in Pediatrics Volume 2012)

Blisters on soles- Syphilitic pemphigus 
(Ref: Giulia Brighi et al. Case Reports in Infectious Diseases Volume 2011, Article ID 235059)

Mulberry like molars 
 (Ref: tuningpp.com)

Early congenital syphilis

1) Hepatosplenomegaly

2) Triad of early congenital syphilis- Rash on palms/Soles + Snuffles + hepatosplenomegaly 

Mucocutaneous (in 30% to 60%)	Snuffles (thick or bloody nasal discharge)- Earliest and the most frequent cutaneous sign ocurring in three-fourth of all pts (MCQ)- 1st week of life Blistering, crusting, desquamation on the palms/soles- Characteristic feature (MCQ) Condyloma lata
Skeletal (in 70% to 80%)- Causes pain on movement- Hence, all movement is restricted (pseudoparalysis of Parrot)	Symmetrical long bone lesions (LL > UL) Metaphyseal osteochondritis Wimberger’s sign (demineralization and destruction of the proximal tibial metaphyses observed on X ray)    (MCQ) Diaphyseal periostitis with periosteal new bone formation Osteitis Dactylitis of the metacarpals, metatarsals, proximal phalanges

Neurosyphilis

Frequently asymptomatic Acute leptomenigitis Chronic meningo vascular syphilis

Late congenital syphilis



Hutchinson triad: Classical Triad of late congenital syphilis- Hutchinson teeth  + Sensorineural deafness + Interstitial keratitis
 

Dental (due to vasculitis of tooth buds)	Hutchinson’s tooth (widely-spaced, peg-shaped, notched upper incisors) (MCQ) Hypoplastic enamel Mulberry molars (a malformed first molar tooth- dwarfing of the cusps and hypertrophy of the enamel surrounding the cusp with masses of globules, giving it the appearance of a mulberry) (MCQ)  Hard palate perforation
Ear	Sensorineural hearing loss due to osteochondritis of otic capsule and cochlear degeneration
Ocular	Interstitial keratitis
Cutaneous	Rhagades (deep fissuring of mucocutaneous junctions in the nares, lips and anus)  (MCQ)
Skeletal	Frontal bossing, square cranium (skull bone periostitis) Short maxilla, high palatal arch and saddle nose deformity (syphilitic nasal chondritis) Saber shins (anterior tibial bowing) (MCQ) Higoumenaki’s sign (sternoclavicular thickening) (MCQ) Clutton’s joints (painless, symmetric hydrarthrosis of the knees and elbows)