Secondary syphilis - Oral Mucosal Lesion
Secondary syphilis typically occurs 1-3 months after the appearance of the primary syphilitic chancre and results from hematologic or lymphatic dissemination of the treponemes. There may be mucocutaneous as well as systemic disease.
Secondary syphilis usually presents with a generalized rash that includes the palms and soles. Condyloma lata may be seen in moist anogenital locations or in the mouth. They are teeming with spirochetes and, therefore, are extremely infectious. Symptoms may include malaise, appetite loss, weight loss, fever, headache, stiff neck, myalgias, lacrimation, photophobia, red and painful eyes, back pain, arthralgias, pharyngitis, flu-like symptoms, pruritus (more common in immunocompromised patients), lymphadenopathy, splenomegaly, bursitis, and tenosynovitis. In late stages blindness and epigastric pain may occur.
The lesions of secondary syphilis heal in 2-10 weeks, with or without treatment.
The secondary stage lasts weeks to months and relapses in about 25% of patients. Vertical transmission transplacentally is sometimes seen. It is more common in men who have sex with men, sex workers, and people exposed to sex workers.
Syphilis is commonly seen in patients with HIV. In the HIV-infected patient look for neurologic, otologic, and ophthalmologic signs of neurosyphilis as well as cutaneous and mucocutaneous lesions. In the HIV-infected patient, primary chancres can persist and multiply.
Ocular screening (eg, slit lamp examination) is advised for patients with suspected or proven syphilis.
Related topics: Primary syphilis, Tertiary syphilis, Early congenital syphilis, Late congenital syphilis, Ocular syphilis
A51.39 – Other secondary syphilis of skin
240557004 – Secondary syphilis