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Acquired syphilis , caused by Response pallid , has afflicted humanity since at least the nth century (6). Although it was a major cause of morbidity and mortality in the nth century, public health programs and the advent of penicillin has reduced its incidence in first world countries many doctors are familiar with the signs and symptoms ( 1 ) . The incidence of acquired syphilis is increasing : in 1990 , the incidence was 20 per 100,000 in the United States and 360 per 100 000 in some parts of Africa , partly due to the HIV epidemic by the human immunodeficiency virus , acquired syphilis with epidemiological linked and co-infection is common ( 7). T. pallid usually spread by contact between infectious epithelial sites and modified less trauma injuries during sex . The baud rate is between 10 % and 60 %
Primary syphilis is defined by a skin lesion , or chancre, in which organisms are identified, but usually occurs 21 days after exposure to the site of inoculation , and is a classic brown - red painless indurating , round papule , nodule or plaque 1-2 cm in diameter. The lesions may be multiple or colitis, and regional lymph nodes may be enlarged .
Results of secondary syphilis of endogenous spread of organisms producing large clinical signs accompanied by systemic symptoms including fever , malaise, and generalized lampshade . Rash occurs, consisting of red-brown maculae and papules, popular lesions evoking psoriasis Gautama and, rarely , pustules (8). Lesions may be annular or vertiginous follicular basis , especially in recurring attacks of secondary syphilis . Other signs include skin alopecia and flat warts , the latter comprising raised , large lesions , gray, confluent popular resulting in tangential areas, hyperemia papules Pamplona face called AA syphilis corn  and , in severe cases , rare ulcerative lesions that define slues maligna.â Some patients develop painless ulcers superficial mucosa.
Meningeal syphilis is usually seen in tertiary syphilis after 7-12 years of disease ( 9), but may occur in the secondary and be symptomatic , usually manifested by a basilar meningitis and may be associated with paralysis of cranial nerve ( 10 ) . Acute transverse mellitus ( 11 ) , agglomeration and self-limited hepatitis other unusual events .
Primary and secondary stage lesions may resolve without treatment or unnoticed by the patient, who then passes a lag phase. These can be divided into beginning and end , an arbitrary distinction that can help to manage the job. The Center for Disease Control has based its distinction early (infectious ) ( non-infectious ) latent stage if the duration of the infection is more or less latent h
1 year , respectively. The World Health Organization uses a period of 2 years to make this distinction. After a variable period of latency , the patient enters the tertiary stage .
Tertiary syphilis includes rubbery skin and mucosal lesions (  tertiary benign syphilis  ) , cardio- vascular disease and neurological manifestations. The skin lesions may be solitary or multiple, and can be divided into rubbery type nodular superficial and deep . The nodular type is soft, atrophic center with a raised border vertiginous . Rubbery lesions present as ulcerative subcutaneous swellings ( 12).
Congenital syphilis, increasingly since the mid-1935 ( 13) is a diagnosis that occurs when organisms are identified by dark-field or immunologic staining of tissue damaged skin , placenta or umbilical cord (14) conventionally stained . A prima facie case of a baby born to a mother with inadequately treated syphilis at the time of delivery, or when a baby or child in a response test for syphilis show signs of congenital syphilis in physical examination radiological or long bone, cerebrospinal fluid reactant or white blood cells high number of unknown cause, or four times higher than that of the mother at birth ( 14) quantitative contrapuntal titles . Clinical signs are rhinitis , cankers , or scaly macula rash (13). Trans placental infection occurs in over 50 % of babies born to mothers with primary or secondary syphilis, 40% of those born to mothers in the early latent stage , and only 10 % of those born to mothers with late latent infection ( 14 ) .

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