Hello, I'm Dr. Smith, and I've specialized in infectious diseases for over 20 years. Syphilis is a complex disease with a variety of presentations, so let's discuss how it might look depending on the stage of infection.

Primary Syphilis

The first noticeable sign of syphilis is typically a chancre. This appears at the original site of infection, usually within 3 weeks of exposure, but it can take anywhere from 10 to 90 days.

What does a chancre look like? It's usually a single, firm, painless, and round sore. While many people imagine a large, open wound, chancres can be quite small and easily missed. They're often described as button-like. The chancre typically develops a clean base and a raised border. Despite being painless, they are teeming with infectious bacteria.

While chancres are most common on the genitals, they can occur anywhere the bacteria entered the body. This includes the:

* Mouth
* Anus
* Rectum
* Fingers
* Lips

Importantly, even without treatment, the chancre will heal on its own within 3 to 6 weeks. This can create the dangerous illusion that the infection is gone when it’s actually progressing to the next stage.

Secondary Syphilis

Without treatment, primary syphilis progresses to the secondary stage. This typically occurs within weeks to months of the chancre healing. The telltale sign of secondary syphilis is a rash. This rash is often described as:

* Rough
* Red
* Brownish-red

The rash usually appears on the palms of the hands and the soles of the feet, which is a key diagnostic clue for doctors. However, it can also affect the trunk, limbs, and even the entire body. Unlike other rashes, the syphilis rash is usually not itchy.

In addition to the rash, secondary syphilis can cause:

* Fever
* Swollen lymph nodes
* Sore throat
* Muscle aches
* Fatigue
* Patchy hair loss
* Headache
* Weight loss

These symptoms can be vague and easily mistaken for other conditions. Similar to the chancre, these symptoms will also resolve without treatment, but the infection persists.

Latent Syphilis

After the secondary stage, syphilis enters a "hidden" phase called latent syphilis. During this stage, there are no visible signs or symptoms of the infection. However, the bacteria remain in the body and can cause serious damage to internal organs if left untreated. Latent syphilis can last for years, even decades.

Tertiary Syphilis

If syphilis remains untreated, it can progress to the tertiary stage. This stage is rare, as most cases are effectively treated with antibiotics. However, tertiary syphilis can be devastating. It can affect multiple organ systems, leading to:

* Heart problems
* Brain damage
* Nerve damage
* Blindness
* Paralysis
* Death

Neurosyphilis

Neurosyphilis is a particularly serious complication of syphilis that can occur at any stage. It develops when the bacteria infect the brain and spinal cord. Symptoms of neurosyphilis can include:

* Headache
* Stiff neck
* Confusion
* Personality changes
* Paralysis
* Dementia

Congenital Syphilis

Syphilis can also be passed from a pregnant woman to her unborn baby. This is called congenital syphilis and can have serious, even fatal consequences for the infant. These can include:

* Premature birth
* Low birth weight
* Bone deformities
* Deafness
* Blindness
* Intellectual disabilities
* Death

Important Note: Syphilis is diagnosed through a blood test. If you suspect you may have been exposed, it's essential to see a doctor as soon as possible. Early diagnosis and treatment are crucial to prevent long-term health problems.

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What do syphilis symptoms look like? The first symptoms of syphilis can take 10 days to 3 weeks to appear after infection. The most common symptom is a painless sore that appears where the virus was transmitted - normally on the penis, vagina or anus. Your lymph glands (in the neck, groin or armpit) may also swell.read more >>