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Secondary syphilis - Hair and Scalp
See also in: Overview,Anogenital,Oral Mucosal Lesion
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Secondary syphilis - Hair and Scalp

See also in: Overview,Anogenital,Oral Mucosal Lesion
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Contributors: Belinda Tan MD, PhD, Mary Gail Mercurio MD, Jeffrey D. Bernhard MD, Lowell A. Goldsmith MD, MPH
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Synopsis

Secondary syphilis is the second stage of the infection caused by the spirochete Treponema pallidum. It typically occurs 1-3 months after the appearance of the primary syphilitic chancre.

Secondary syphilis usually presents with a generalized rash that includes the palms and soles. Patchy alopecia may be observed on the scalp. 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, 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. If left untreated, up to 25% of patients will relapse within the first 2 years.

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

Codes

ICD10CM:
A51.39 – Other secondary syphilis of skin

SNOMEDCT:
240557004 – Secondary syphilis

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

The following differential will be focused on the cutaneous findings of secondary syphilis.

Patchy Alopecia
Skin

Best Tests

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Management Pearls

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Therapy

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References

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Last Updated: 12/06/2017
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Secondary syphilis - Hair and Scalp
See also in: Overview,Anogenital,Oral Mucosal Lesion
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Secondary syphilis : Headache, Rash, Lymphadenopathy, Oral white plaque, Arthralgia, Myalgia, Pharyngitis, Sexual promiscuity, Scaly papules
Clinical image of Secondary syphilis
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