Secondary Syphilis

Patients may report flu-like symptoms, fatigue, sore throat, or headaches, accompanied by a rash. They may mention a painless ulcer that healed weeks prior, and recent unprotected sexual contact. Secondary syphilis is linked to high-risk sexual behaviors. 

Characteristic findings include a widespread, non-itchy rash, particularly on the palms and soles, and wart-like growths in moist areas. Alopecia or patchy hair loss may be visible. 

1. Primary Medication:

   • Benzathine Penicillin G (2.4 million units IM, single dose) is the first-line treatment. For penicillin-allergic patients, doxycycline (100 mg orally, twice daily for 14 days) or tetracycline (500 mg orally, four times daily for 14 days) may be used.

2. Follow-Up:

   • Monthly follow-up with RPR (rapid plasma reagin) or VDRL tests is recommended to monitor treatment response.

Risk Factors, Prognosis, and Complications
With treatment, the prognosis is excellent, but untreated cases may progress to tertiary syphilis, affecting organs and nerves. Reinfection risk remains high without behavioral interventions.