SIGNS OF SYPHILIS

The first symptoms of syphilis may go undetected because they are very mild and disappear spontaneously. The initial symptom is a chancre; it is usually a painless open sore that usually appears on the penis or around or in the vagina. It can also occur near the mouth, anus, or on the hands. If untreated, syphilis may go on to more advanced stages, including a transient rash and, eventually, serious involvement of the heart and central nervous system. The full course of the disease can take years. Penicillin remains the most effective drug to treat people with syphilis.
The initial infection causes an ulcer at the site of infection; however, the bacteria move throughout the body, damaging many organs over time. Medical experts describe the course of the disease by dividing it into four stages – primary, secondary, latent, and tertiary (late). An infected person who has not been treated may infect others during the first two stages, which usually last one to two years. In its late stages, untreated syphilis, although not contagious, can cause serious heart abnormalities, mental disorders, blindness, other neurologic problems, and death.
Secondary syphilis is often marked by a skin rash that is characterized by brown sores about the size of a penny. The rash appears anywhere from three to six weeks after the chancre appears. While the rash may cover the whole body or appear only in a few areas, the palms of the hands and soles of the feet are almost always involved. Because active bacteria are present in these sores, any physical contact – sexual or nonsexual – with the broken skin of an infected person may spread the infection at this stage. The rash usually heals within several weeks or months. Other symptoms also may occur, such as mild fever, fatigue, headache, sore throat, as well as patchy hair loss, and swollen lymph glands throughout the body. These symptoms may be very mild and, like the chancre of primary syphilis, will disappear without treatment. The signs of secondary syphilis may come and go over the next one to two years.
If untreated, syphilis may lapse into a latent stage during which the disease is no longer contagious and no symptoms are present. Many people who are not treated will suffer no further consequences of the disease. Approximately one-third of those who have secondary syphilis, however, go on to develop the complications of late, or tertiary, syphilis, in which the bacteria damage the heart, eyes, brain, nervous system, bones, joints, or almost any other part of the body. This stage can last for years, or even for decades. Late syphilis, the final stage, can result in mental illness, blindness, other neurologic problems, heart disease, and death

(Source: excerpt from Syphilis, NIAID Fact Sheet: NIAID)