Secondary Syphilis

Definition
  • Secondary Syphilis describes the second stage of clinical consequences which arise following inoculation with T. pallidum.
Chronology
  • The signs of Secondary Syphilis usually arise 6-8 weeks after the lesion of Primary Syphilis spontaneously resolves. In a small minority of patients Primary and Secondary Syphilitic symptoms may overlap. Secondary Syphilis usually resolves spontaneously about 1-6 months after the onset of symptoms and enters a Latent phase.
Clinical Consequences
  • Mucocutaneous Symptoms
    • Secondary Syphilis is heralded by the appearance of characteristic lesions on mucous membranes and the skin. The rash is composed of reddish/pinkish macules or papules that are diffusely distributed but characteristically involve the palms and soles of the hands and feet.
    • In moist areas of skin such as the axillae, vagina, scrotum, and Peri-anal region, papules can enlarge and are described as "Condyloma Lata" which are highly infectious structures due to their capacity to shed large numbers of spirochetes.
  • Generalized Lymphadenoapthy
    • Secondary Syphilis is characterized by a generalized, non-tender lymphadenopathy of lymph nodes throughout the body.
  • Kidney
    • In a fraction of patients development of immune complexes during Secondary Syphilis leads to glomerular disease characterized by Membranous Glomerulonephritis.