How long after the disappearance of a chancre does secondary syphilis occur?

Written by Luo Hong
Dermatology Department
Updated on May 13, 2025
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Secondary syphilis generally occurs three to four weeks after the disappearance of the primary chancre, which means it often occurs 9 to 12 weeks after the infection by the Treponema pallidum. Of course, it is rare yet possible for it to appear simultaneously with the primary chancre. The main reason secondary syphilis develops is either due to untreated primary syphilis or incomplete treatment. The Treponema pallidum enters the bloodstream from the lymphatic system, causing bacteremia and spreading throughout the body, leading to systemic damage including skin and mucosal lesions, known as secondary syphilis. Common signs of secondary syphilis include erythema on the palms and soles, which is a characteristic manifestation. Another sign includes flat, moist warts around the anus and genital areas, similar to condyloma acuminatum, but these warts are flatter and less protruding.

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Does third-stage syphilis have transmissibility?

Syphilis is a disease that often causes fear among the general population. Syphilis is divided into three stages: primary, secondary, and tertiary, with tertiary syphilis being the most infectious stage. Syphilis is a chronic systemic infectious disease caused by the infection of the Treponema pallidum bacterium. It has a wide range of transmission methods, including sexual transmission, blood transmission, and mother-to-child transmission, among others. Therefore, the infectiousness of tertiary syphilis is the strongest, and everyone should pay extra attention and take precautions.

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Is severe oral ulceration related to syphilis?

Oral ulcers are a type of erosion of the mucous membrane in the mouth and are commonly seen in clinical settings; they are a common disease. Syphilis, on the other hand, is a viral infection unrelated to oral ulcers, so it is recommended that patients be aware to differentiate them. Furthermore, it is crucial for patients to pay attention to their lifestyle habits and personal hygiene. When oral ulcers occur, it is appropriate to use some medications for oral ulcers for application, which can effectively treat the ulcerated surface of the mouth. Moreover, if a patient experiences severe, recurrent oral ulcers, it is advised to seek medical diagnosis at a hospital to exclude the possibility of other systemic diseases causing the ulcers. Additionally, patients should maintain good oral hygiene daily to develop healthy oral habits.

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Third-stage syphilis has no symptoms.

Once tertiary syphilis has developed, it is highly unlikely for there to be no symptoms. Tertiary syphilis is a late stage of the disease, generally involving the skin, mucous membranes, cardiovascular system, and even the motor and nervous systems. If there are no symptoms present, it is generally not possible to be in the tertiary stage of syphilis. Therefore, if tertiary syphilis occurs, it will not be without symptoms.

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How long does tertiary syphilis appear?

Tertiary syphilis often appears two to three years after contracting syphilis. Syphilis is staged based on the time of onset, and is typically divided into primary, secondary, and tertiary stages. Tertiary syphilis is the latest and most severe stage among these, often affecting the heart, nervous system, skin, and other areas. Due to the risk of severe complications, early and timely treatment is recommended to prevent the occurrence of tertiary syphilis.

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Can tertiary syphilis be treated?

Third-stage syphilis is treatable, but typically, it develops two to three years after the initial syphilis infection, making it more severe than both the first and second stages—this is what we refer to as late-stage syphilis. Therefore, treating third-stage syphilis is somewhat more challenging than treating the first and second stages. Additionally, third-stage syphilis particularly tends to cause damage to cardiovascular, neurological, joint, and other organ systems. If it leads to severe complications, it can easily result in deformities, disabilities, or even death. Therefore, it is crucial to be especially vigilant if diagnosed with third-stage syphilis and to seek timely treatment at a hospital.