Syphilis - secondary

Alternative names:

secondary syphilis

Definition:

The second stage of the sexually transmitted disease, syphilis, that begins a week to 6 months after the initial infection.

Causes, incidence, and risk factors:

Syphilis is a sexually-transmitted infectious disease caused by the spirochete Treponema pallidum. Syphilis has three stages: primary syphilis, secondary and tertiary syphilis.

The secondary stage can begin a week to 6 months after the primary stage. A generalized skin rash is the hallmark of this stage. The rash may resemble many different diseases and subsequently this stage of syphilis has been called the "great impostor".

The classical skin lesions of secondary syphilis are scaly reddish-brown papules or plaques. Syphilis is one of the few diseases in which the skin lesions are also seen on the palms and soles and are very obvious. This stage may last for up to six weeks and may be accompanied by systemic symptoms such a fever, achy muscles (myalgia) and achy joints (arthralgia). Other lesions which can appear are moist warty patches on the genitalia called condylomata lata.

Syphilis is very contagious in both the primary and secondary stages. A history of a genital sore or ulcer weeks before the appearance of the rash should raise suspicion of syphilis about any rash that is generalized and also present on both the palms of the hands and soles of the feet.

Following the clearing of the second stage of syphilis the infection can become "latent". During this stage there are no overt signs of infection but the organisms continue to reproduce within the body.

High risk populations include individuals with multiple sex partners, unknown partners or partners who engage in any other high risk sex practices. Syphilis is more prevalent in larger metropolitan areas, and among the lower socioeconomic classes. The incidence of secondary syphilis is 3 out of 10,000 people.