What are the symptoms of syphilis?

Written by Qu Jing
Dermatology
Updated on March 26, 2025
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Syphilis is divided into acquired syphilis and congenital syphilis, which is transmitted via the fetus. Acquired syphilis, based on the duration of the disease and using two years as a boundary, is further divided into early-stage syphilis and late-stage syphilis. Early-stage syphilis, particularly primary syphilis, mainly presents symptoms such as a chancre and scleradenitis, generally without systemic symptoms. Secondary syphilis occurs when primary syphilis is untreated or not completely treated, allowing the virus to enter the bloodstream from the lymphatic system and spread throughout the body. This causes damages to the skin, mucous membranes, and systemically, known as secondary syphilis. It can manifest as various forms of syphilitic rash, some resembling papular rashes, others similar to dermatitis, eczema, flat lichen, urticaria, psoriasis, pustular disease, and others. Some secondary syphilitic rashes are similar to flat genital warts, and sometimes syphilis can lead to alopecia. Syphilis can also affect mucous membranes, appearing in the mouth, tongue, pharynx, larynx, and genital mucous membranes, characterized by one or more areas of distinct erythema, vesicles, erosion, covered with a grayish-white membrane, generally painless. Some syphilis cases might affect bones, causing damage to bones and joints. Latent syphilis presents no obvious symptoms, and late-stage syphilis might involve the cardiovascular and nervous systems.

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Written by Huang Ling Juan
Dermatology
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What are the early symptoms of syphilis in men?

Early symptoms of syphilis in men may include small papules, with the characteristic lesion of early syphilis being a chancre. From the infection with the syphilis spirochete to the appearance of skin symptoms, it usually takes about three weeks on average. The syphilis chancre in men is typically found on the genitals, though a minority may appear in the mouth. The earliest form of a chancre is a solitary papule, which gradually develops into a round or oval-shaped ulcer. The ulcer has clear boundaries, slightly raised edges, and a clean base, feeling firm like cartilage to the touch, without significant pain. When a chancre appears, if a secondary bacterial infection occurs, pain may arise. Men infected with syphilis must seek early treatment as early-stage syphilis can be completely cured.

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Written by Huang Ling Juan
Dermatology
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What are the symptoms of syphilitic disease?

The symptoms of syphilitic disease are diverse, and syphilis is divided into early syphilis and late syphilis. In the early stages of syphilis, during the primary phase, it usually presents as a hard chancre on the genital area, without obvious pain. In secondary syphilis, it manifests as polymorphic roseola, usually appearing as patches of varying sizes on the trunk, covered with scales, with no significant itching. In tertiary or late syphilis, there can be damage to multiple systems including bones and nerves. Once syphilis is diagnosed, it is essential to treat it early. Early treatment generally leads to good outcomes, with most people recovering. If it progresses to late stages, treatment outcomes are relatively poor. The first choice of treatment for syphilis is long-acting penicillin.

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Written by Zhu Zhu
Dermatology
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How should tertiary syphilis be managed?

The treatment and management of tertiary syphilis is a challenging process since it is a late stage of the disease, affecting the skin, bones, mucous membranes, cardiovascular system, nerves, and potentially triggering diseases in various bodily systems. For managing tertiary syphilis, it is recommended to consume high-protein and high-vitamin foods such as apples, bananas, green vegetables, and radishes. It is crucial to seek timely medical treatment at a hospital and address any complications that arise, which can help in gradually managing and alleviating the condition of tertiary syphilis.

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Written by Fu Ye Song
Hematology
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Can a routine blood test detect syphilis?

Syphilis is a contagious disease, and we cannot detect syphilis through routine blood tests, as these tests only measure elements such as the number of white blood cells, red blood cells, and platelets in the blood. Since syphilis is caused by an infectious agent, it cannot be detected through routine blood tests. It can only be detected by checking for antibodies using methods like ELISA immunofluorescence. Therefore, routine blood tests cannot detect syphilis.

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Written by Zhu Zhu
Dermatology
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Can third-stage syphilis be completely cured?

Third-stage syphilis and late-stage syphilis generally have a longer duration, with many cases exceeding two years. Third-stage syphilis can cause damage to the cardiovascular and nervous systems, and there may be residual symptoms after improvement. However, with persistent long-term standard treatment, it is still possible to achieve a cure. Therefore, if one contracts third-stage syphilis, it is crucial to adhere to the treatment and cooperate actively with the therapy.