Signs and Symptoms
Initially, a dusky red, flat spot appears at the site of inoculation and is easily missed. Then, a painless ulcer (chancre) appears 18–21 days after initial infection. Genital sites in females affected are the cervix, vagina, vulva, and clitoris. Cervical and vaginal infections may not be recognized. In men, the chancre is easily seen on the penis. Other sites are limited only by human ingenuity and imagination. Other common sites for syphilis are around the mouth (perioral) and between the buttocks (perianal) areas.
Chancres vary in size from a few millimeters to several centimeters. A chancre is usually painless, solitary, and shallow, with a sharp border and a raised, hard edge. About 70–80% of patients have rubbery, non-tender, swollen lymph nodes, often on only one side of the groin, during the first week of infection.
If untreated, the chancre will remain present for 1–6 weeks. If treated, it heals without scarring in 1–2 weeks.
Who's At Risk
