Syphilis physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S. [2]

Overview

Syphilis is a curable sexually transmitted disease caused by the Treponema pallidum spirochete. The route of transmission of syphilis is almost always by sexual contact, although there are examples of congenital syphilis via transmission from mother to child in utero. The signs and symptoms of syphilis are numerous; before the advent of serological testing, precise diagnosis was very difficult.

History & Symptoms

Primary syphilis: Chancre

• Single painless papule which rapidly progresses an ulcerated, indurated lesion
• Chancre is usually located on the penis,cervix, labia, anal canal, rectum or oral cavity
• Regional lymphadenopathy accompanies primary lesion.

• Onset within a week
• Lymph nodes are firm, painless, non-tender and non-suppurative

• Primary chancre heals spontaneously within 4-6weeks; however, regional lymphadenopathy may persist for longer periods.

Secondary syphilis: Condylomata Lata

• Develops 6-8weeks after the appearance of primary chancre.
• Cardinal signs include:

• Skin rash: initial macular lesions on the trunk and proximal limbs with progressive generalized papular rash and may cause necrotic ulcers.
• Mucosal patches'
• Generalized lymphadenopathy: generalized, firm, non-tender
• Condylomata lata: papular lesions in the intertriginous areas enlarge with progressive erosion resulting in broad, grey-white highly infectious lesions called condylomata lata.

• 
  Erruption on Sole of Foot Associated with Secondary Syphilis.
• 
  Generalized (Maculo-Papular) Eruption Associated with Secondary Syphilis.
• 
  Palmar Erruption Associated with Secondary Syphilis.
• 
  Palmar Erruption Associated with Secondary Syphilis.

References

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