Secondary syphilis is a stage of a bacterial infection caused by Treponema pallidum. This stage typically appears a few weeks after the initial sore (chancre) has healed, or sometimes while it is still present. It manifests with a wide array of visible signs affecting the skin and mucous membranes.
The Characteristic Rash
A hallmark of secondary syphilis is a widespread rash. This rash often appears as rough, red, or reddish-brown spots that typically do not itch. It commonly begins on the trunk of the body, including the chest, stomach area, and back, before potentially spreading to the limbs.
A distinguishing feature of this rash is its frequent involvement of the palms of the hands and soles of the feet. While rashes from other conditions might resemble those of secondary syphilis elsewhere on the body, this specific distribution on the palms and soles is a strong indicator. The rash can vary in appearance, sometimes presenting as macules (flat spots), papules (small raised bumps), or even plaques.
The rash can be so faint that it goes unnoticed by the individual. Without treatment, these skin manifestations may spontaneously resolve, but the underlying infection remains in the body and can recur.
Other Recognizable Skin and Mucous Lesions
Secondary syphilis can also lead to other distinct visible lesions on the skin and mucous membranes. One manifestation is condyloma lata, which presents as moist, wart-like growths. These lesions are typically flat, velvety, and broad-based, often appearing in warm, moist areas of the body.
Condyloma lata commonly form in regions like the groin, around the anus, under the breasts, or in other skin folds. These growths contain a high concentration of the bacteria and are highly infectious. They can be painless or, in some instances, cause discomfort.
Another type of lesion is mucous patches, which are painless white or grayish areas that appear on mucous membranes. These can be found inside the mouth, on the tongue, throat, or genitals. Mucous patches may be slightly raised and covered by a white or grayish film.
Associated Visible Changes
Secondary syphilis can also lead to other visible changes, particularly affecting hair. Patchy hair loss, known as syphilitic alopecia, often has a characteristic “moth-eaten” appearance.
This “moth-eaten” pattern involves small, irregularly shaped patches where hair is thinned but not completely absent. While most commonly observed on the scalp, it can also affect other hair-bearing areas such as the eyebrows or beard. This type of hair loss is typically non-scarring and usually resolves with appropriate treatment for syphilis.
When to Seek Medical Evaluation
Observing any of the described visible signs warrants prompt medical evaluation. Self-diagnosis is not sufficient for syphilis, as its symptoms can mimic other conditions. A healthcare provider can perform the necessary tests, such as blood tests, to confirm a diagnosis.
While symptoms may disappear on their own, the infection remains in the body and can lead to serious, long-term health complications if left untreated. Consulting a medical professional ensures accurate diagnosis and effective management.