(d) Maculopapular skin rash (raised lesions on discolored skin). A pale
red or pinkish rash is often found on the palms and soles of the patient's feet.
(e) Seldom purpuric; that is, rarely is there spontaneous bleeding
causing purpura (a small hemorrhage on the skin, mucous membrane, or serosal
Hair loss (alopecia).
Inflammation of the bone (osteitis).
Inflammation of the iris (iritis).
Signs and symptoms of syphilis in the secondary stage are varied giving this
stage of the disease the nickname "the great imitator."
(3) Latent ("hidden") syphilis. Ineffectively treated syphilis or untreated
syphilis passes into this third state. The latent syphilis stage is further divided into two
stages: the early latent syphilis stage and the late latent syphilis stage.
(a) Latent syphilis stage. In the early latent syphilis stage, defined as
being the first two years after initial infection, infectious lesions may recur. During this
period, the patient may appear to have no physical signs. The only significant
laboratory finding is a positive serologic test.
(b) Late latent syphilis stage. This stage is defined as being more than
two years after infection. In this stage, the patient has no physical signs, and recurring
infectious lesions are rare. This stage may last a few years or the rest of the patient's
life. In untreated cases, about one third of those infected will develop tertiary (late)
(4) Tertiary (late) syphilis stage. This stage of the disease involves serious
problems and is the final, destructive but noninfectious stage of syphilis. Complications
from the medical problems of this stage can cause paralysis, insanity, blindness, and
death. Health problems which follow are characteristic of this stage of syphilis: