secondary syphilis

Introduction

see syphilis

Etiology

• unprotected intercourse with individual infected with syphilis
• failure to recognize or to treat primary syphilis

Pathology

• infection with Treponema pallidum (syphilis)
• hematogenous dissemination involving many organs, most often the skin, liver, & lymph nodes
• elongation of rete ridges, interface dermatitis, endothelial edema, lymphocytic & plasma cell infiltrate
• immunostaining may reveal Treponema pallidum within the lower 1/3 of the epidermis

Clinical manifestations

• develops 2 to 8 weeks after the appearance of the primary chancre
• fever
• generalized weakness
• generalized mucocutaneous rash
• diffuse rash affecting the trunk & palms of hands & soles of feet
  • maculopapular, hyperpigmented, & scaly eruption on palms, soles & trunk
  • hypopigmented plaques on genitals
  • papulosquamous lesions on the trunk
  • copper-colored papules on the palms & soles with peripheral adherent scale
    • Biett sign
  • rash is not vesicular
• generalized lymphadenopathy

* see images

Laboratory

• fluorescent treponemal antibody absorption test is reactive
• elevated titer of rapid plasma reagin test
• HIV1 RNA

Management

• intramuscular penicillin G benzathine

More general terms

• syphilis