Typically acquired by direct sexual contact. Primary ulcer is located at the entry point, incubation period is about 3 weeks and variable. The ulcer is followed (after 1 week) by regional lymphadenitis. After 4 – 6 weeks the lesion heals without therapy.

Secondary, disseminated syphilis appears 8 weeks after the primary ulcer appeared (which at this time may be healed): symmetric mucocutaneous rash. Typical lesions: palms, soles. Condylomata lata of mucous membranes appear in cca 30% of cases. These lesions dissapear after several weeks. In one third of the patients the disease is cured, in the rest follows the latent stage, lasting many years (with seropositivity, antibodies against treponema within the serum).

Latent syphilis lasts for many years. Relapses may occurr.

Tertiary syphilis: granulomas (gumma) of various organs, vascular damage (aorta), neurologic changes (progressive paralysis, tabes dorsalis).

Fetus can get infected after fourth month of gravidity, causing variable (often severe) damage to the fetus or fetal loss (diagnosis and therapy is necessary).

• specific signs and many unspecific features mimicking other dermatoses
• I. stage, primary syphilis: ulcus durum of the penis (esp. of the sulcus coronarius), vulva, cervix uteri, perianal and oral ulcerations; painless or slightly sensitive
• II. stage, secondary syphilis: condylomata lata of the genital, oral mucous plaques, recurrent maculopapulous exanthema, leukodermata syphilitica, alopetia areolaris
• III. stage, tertiary syphilis: gummata, tuberoserpiginous and ulceroserpiginous lesions
• neurosyphilis: progressive paralysis, tabes dorsalis