What is syphilis?

Syphilis is a sexually transmitted disease caused by the bacterium Treponema pallidum.

The hallmark symptom of syphilis, typically seen in the initial stage, is a painless ulcer, known as a chancre, predominantly appearing in the genital region. The most significant risk of transmission comes from individuals in the primary or secondary stages of the disease, particularly when active lesions are present on their sexual organs.

Before showing the pictures, here’s a succinct overview of the three distinct stages of syphilis.

Stages of Syphilis

The initial or primary stage of syphilis is perhaps the most recognizable, marked by the presence of a genital sore, known as a chancre. This lesion, persisting for 3 to 6 weeks, may resolve itself without any intervention, which can misleadingly suggest self-resolution of the disease.

Following the disappearance of the chancre, after a period of weeks or months, syphilis reemerges in its secondary stage. This phase may present with skin lesions and mucous membrane involvement. If untreated, these symptoms may temporarily subside, only to resurface years later in the form of tertiary syphilis. This is the most severe stage of the disease, posing a high risk of producing disfiguring lesions.

The photo gallery below offers a visual journey through the primary, secondary, and tertiary stages of syphilis. The highly disfiguring lesions of tertiary syphilis displayed are infrequent in today’s medical landscape due to timely and effective treatments. However, such manifestations were relatively common in the era preceding antibiotics.

If you want to read more about syphilis, we recommend the following article: Syphilis: Symptoms, Tests, Transmission, Treatment, and Cure.

Caution: The following gallery contains graphic images depicting the primary, secondary, and tertiary stages of syphilis. These images consist of visually intense and disfiguring lesions or representations of sexual organs. We encourage discretion and recommend that you refrain from accessing this gallery if your current environment is not conducive to the viewing of such content.

Images and photos

Primary syphilis – Syphilitic chancre

Genital ulcer - Primary syphilis — Genital ulcer – Primary syphilis

Tongue ulcer - Primary syphilis acquired by oral sex — Tongue ulcer – Primary syphilis acquired by oral sex

Secondary syphilis

Photos of the syphilis rashes on the soles, palms, body, and oral cavity.

Secondary syphilis - Rash on the back — Secondary syphilis – Rash on the back

Secondary syphilis - Reddish purple spots on the palms — Secondary syphilis – Reddish purple spots on the palms

Secondary syphilis - Eruptions on the palms and soles — Secondary syphilis – Eruptions on the palms and soles

Severe secondary syphilis (malignant syphilis) with lesions all over the body

Secondary syphilis - lesions on the hard palate — Secondary syphilis – Lesions on the hard palate

Secondary syphilis lesions on the tongue

Pustular secondary syphilis - rare and aggressive form — Pustular secondary syphilis – rare and aggressive form

Tertiary syphilis – Syphilitic Gumma

Syphilitic gumma on the hand - Tertiary syphilis — Syphilitic gumma on the hand – Tertiary syphilis

Syphilitic gumma on the face - Tertiary syphilis — Syphilitic gumma on the face – Tertiary syphilis

Disfiguring tertiary syphilis - Common findings before the antibiotic era — Disfiguring tertiary syphilis – Common findings before the antibiotic era

Effects of tertiary syphilis on a patient's skull — Effects of tertiary syphilis on a patient’s skull

Destruction of nasal cartilage due to tertiary syphilis

Credits

Shutterstock.com
Multiple skin ulcers from malignant syphilis – The Lancet
Secondary Syphilis in Cali, Colombia: New Concepts in Disease Pathogenesis – Scientific Figure on ResearchGate. Available from: https://www.researchgate.net/figure/Palmar-and-plantar-rash-of-secondary-syphilis-Typical-palmar-and-plantar-rash-of_fig8_44630365 [accessed 26 Apr, 2023]
Morais, Lima & Melo, Thayná & Kitakawa, Dárcio & Da, Felipe & Peralta, Felipe & Gonzales, Sabrina & Carvalho, Luis Felipe & Carvalho, Silva. (2022). Secondary syphilis in oral cavity: Case report and literature review. International Journal of Case Reports and Images. 13. 226-229. 10.5348/101366Z01TM2022CR.
Tertiary syphilitic ulceration of the scalp – St Bartholomew’s Hospital Archives & Museum.
An Alaskan Inuit skull, showing the effects of syphilis. Photograph by Ales Hrdlicka, ca. 1910.
A man suffering from syphilis, displaying pustular syphiloderm lesions on his scalp and torso. Process print after a photograph, ca. 1905.
Face of a woman with a typical ‘syphilitic nose’. Picture: St Bartholomew’s Hospital Archives & Museum.

Author(s)

Dr. Pedro Pinheiro

Pedro Pinheiro holds a medical degree from the Federal University of Rio de Janeiro (UFRJ) and is a specialist in Internal Medicine and Nephrology, certified by the State University of Rio de Janeiro (UERJ) and the Brazilian Society of Nephrology (SBN). He is currently based in Lisbon, Portugal, with his credentials recognized by the University of Porto and the Portuguese Nephrology Specialty College.

7 responses to “Pictures: Syphilis – All stages [Warning: Strong Images]”

Alan Robinson

June 27, 2024

Hello, my wife who is going through the menopause has been experiencing pain in her muscles, neck, arms, buttocks, thighs, inner thighs,legs, head and feet. She counters this by whacking the painful areas with a ‘massager’ which typically eventually brings out a purple rash or large purple spots. Nothing seems to be assisting this. We need help and do not understand the cause.

Dr. Pedro Pinheiro

July 2, 2024

I’m sorry to hear about the difficulties your wife is experiencing. Menopause can bring about various symptoms, and muscle and joint pain are among them due to hormonal changes, particularly the decrease in estrogen levels. However, the severity and distribution of pain your wife is experiencing, coupled with the purple rashes or spots, may indicate additional underlying conditions or complications that need to be addressed. A more in-depth investigation is needed, especially into the bruising that she develops from the massages.

Reply

Becky

April 1, 2024

If someone has syphilis and it’s already developing dementia, how long does that person usually live?

Dr. Pedro Pinheiro

May 1, 2024

Estimating the life expectancy for someone with neurosyphilis who has developed dementia can be challenging without specific details about the individual’s overall health, treatment response, and extent of neurological damage.

Historically, before the era of antibiotics, neurosyphilis was usually fatal. Life expectancy after the onset of dementia symptoms in untreated cases might range from a few months to a few years. Typically, the progression from symptom onset to death ranged from 2 to 5 years. With effective antibiotic treatment, the progression of the disease can be halted, and in some cases, symptoms may stabilize or partially improve. This treatment can potentially extend life expectancy significantly, depending on how early the disease is detected and how well the person responds to treatment. Individuals might live many years with a stable condition, although they may still experience significant neurological impairments.

Reply

Amos tum

October 2, 2023

Please need a treatment

Dr. Pedro Pinheiro

October 14, 2023

Amos, in order to treat your syphilis, you need to be evaluated by a doctor. Syphilis treatment is very simple and the success rate is high.

Reply

mohammed al hassan

May 30, 2023

good job

Alan Robinson

June 27, 2024

Hello, my wife who is going through the menopause has been experiencing pain in her muscles, neck, arms, buttocks, thighs, inner thighs,legs, head and feet. She counters this by whacking the painful areas with a ‘massager’ which typically eventually brings out a purple rash or large purple spots. Nothing seems to be assisting this. We need help and do not understand the cause.

1. Dr. Pedro Pinheiro
  
  July 2, 2024
  
  I’m sorry to hear about the difficulties your wife is experiencing. Menopause can bring about various symptoms, and muscle and joint pain are among them due to hormonal changes, particularly the decrease in estrogen levels. However, the severity and distribution of pain your wife is experiencing, coupled with the purple rashes or spots, may indicate additional underlying conditions or complications that need to be addressed. A more in-depth investigation is needed, especially into the bruising that she develops from the massages.
  
Becky

April 1, 2024

If someone has syphilis and it’s already developing dementia, how long does that person usually live?

1. Dr. Pedro Pinheiro
  
  May 1, 2024
  
  Estimating the life expectancy for someone with neurosyphilis who has developed dementia can be challenging without specific details about the individual’s overall health, treatment response, and extent of neurological damage.
  
  Historically, before the era of antibiotics, neurosyphilis was usually fatal. Life expectancy after the onset of dementia symptoms in untreated cases might range from a few months to a few years. Typically, the progression from symptom onset to death ranged from 2 to 5 years. With effective antibiotic treatment, the progression of the disease can be halted, and in some cases, symptoms may stabilize or partially improve. This treatment can potentially extend life expectancy significantly, depending on how early the disease is detected and how well the person responds to treatment. Individuals might live many years with a stable condition, although they may still experience significant neurological impairments.
  
Amos tum

October 2, 2023

Please need a treatment

1. Dr. Pedro Pinheiro
  
  October 14, 2023
  
  Amos, in order to treat your syphilis, you need to be evaluated by a doctor. Syphilis treatment is very simple and the success rate is high.
  
mohammed al hassan

May 30, 2023

good job

Pictures: Syphilis – All stages [Warning: Strong Images]