Macular syphilide (roseolar rash) is the earliest syphilide and appears like symmetrical, round or oval coppery-red macules, nonpruritic, nonscaling, on the trunk and on the inner surfaces of the extremities.
Secondary syphilides can mimick a lot of dermatological diseases, from exantema to acne and even psoriasis.
Papular syphilides are nonpruritic, round or oval papules, 3 mm in diameter.
Papular syphilides tend to be disseminated but may also be localized, asymmetrical, configurate, confluent, etc.
The secondary syphilides may appear like any dermatological diseases, such as lichen planus, psoriasis, parapsoriasis, seborrheic dermatitis, acne vulgaris, impetigo, scabies, condylomata acuminata, etc--all of this making the clinical diagnosis quite difficult.
They are represented by nodular or tubercular syphilides, which most often occur 3 to 5 years after infection.
Early congenital syphilis emerges in the first two years of life, and skin lesions are much like the secondary syphilides from the acquired syphilis: papular, papuloscuamous syphilides, deeply fissured papules of the mouth angles or the nostrils, condylomata lata (usually in the first year, hardly in the newborn period), pemphigus syphiliticus: bullae on the red infiltrated base, localized on the palms and soles, with rupture and leaving exuding areas.