rhagades
Summary
Rhagades are linear scars radiating from the corners of the mouth, nose, and anus, produced by healing of the perioral inflammatory lesions of congenital syphilis. They are a late stigma of untreated congenital infection.
Detail
In early congenital syphilis the infant develops a maculopapular rash that often involves the palms and soles, persistent blood-stained nasal discharge called snuffles, hepatosplenomegaly, and osteochondritis with pseudoparalysis of Parrot. Fissuring around the mouth and nares from this perioral involvement heals with the radiating linear scars called rhagades. Late congenital stigmata, appearing after two years, form a recognizable set: Hutchinson teeth (notched, widely spaced upper central incisors), mulberry molars, interstitial keratitis, sensorineural deafness — the last three together comprising the Hutchinson triad — plus saddle nose deformity, saber shins, frontal bossing, and Clutton joints. Rhagades should not be confused with angular cheilitis from riboflavin or iron deficiency or candidal infection, which is inflammatory and reversible rather than scarred. Prevention is by screening all pregnant women and treating maternal syphilis with penicillin, the only agent adequate in pregnancy, with desensitization if allergic.
Sources
- Nelson Textbook of Pediatrics
- First Aid for the USMLE Step 1
Reviewed by AnkiBoss editorial — medical student review. Information here is for study reference only and is not medical advice. Spotted an error? Let us know.