• Alopecia
• Acniform eruptions
• Benign tumors
• Bullous diseases
• Dermoscopy
• Nevi, melanoma
• Nonmelanoma cancer
• Psoriasis and others
• Stds
• Vascular tumors
• Vulvar disease

• Herpes simplex
• Genital Herpes Simplex Introduction STD
• Genital Herpes Simplex Risk factors and Rate of Transmission
• Previous HSV type 1 infection
• Genital Herpes Simplex Primary and Recurrent Infections
• Genital Herpes Simplex Signs and Symptoms
• Genital Herpes Simplex Latency and Reactivation STD
• Genital Herpes Simplex Recurrent Infection STD
• Genital Herpes Simplex Frequency of Recurrence
• Genital Herpes Simplex Anatomic Site
• Genital Herpes Simplex Asymptomatic transmission
• Genital Herpes Simplex Prevention
• Genital Herpes Simplex Laboratory diagnosis
• Genital Herpes Simplex Serology
• Genital Herpes Simplex Testing Pregnant Women
• Genital Herpes Simplex Monogamous Couples
• Genital Herpes Simplex STD Treatment
• Genital Herpes Simplex Daily Treatment Suppressive Therapy
• Genital Herpes Simplex During Pregnancy
• Warts (HPV infection)
• Genital Warts HPV Introduction and Causes STD
• Genital Warts HPV Screening Tests
• Genital Warts HPV Interpretation of Test Results
• Genital Warts HPV The HPV DNA Test
• Genital Warts HPV Lesion and Location
• Genital Warts HPV Lesion Types STD
• Genital Warts HPV Subclinical Lesions
• Genital Warts HPV Bowenoid Papulosis STD
• Genital Warts HPV Clinical Evaluation STD
• Genital Warts HPV Differential diagnosis
• Genital Warts HPV Treatment STD
• Genital Warts HPV Treatment Approach to Therapy
• Molluscum Contagiosum
• Molluscum Contagiosum STD Introduction
• Molluscum Contagiosum Clinical manifestations
• Molluscum Contagiosum Diagnosis
• Molluscum Contagiosum Treatment
• Syphilis
• Syphilis Epidemiology STD
• Syphilis Treponema Pallidum
• Syphilis Causes STD
• Incubating Syphilis
• Secondary Syphilis STD
• Syphilis Latency
• Congenital Syphilis
• Early Congenital Syphilis
• Late Congenital Syphilis
• Syphilis Laboratory Diagnosis
• Syphilis Serologic Tests
• Syphilis Nontreponemal Reaginic Tests
• Syphilis Specific Treponemal Tests
• False-Positive Serologic Test for Syphilis
• Syphilis Treatment STD
• Chancroid
• Chancroid STD Introduction
• Chancroid Clinical presentation
• Chancroid Diagnosis
• Chancroid Treatment STD
• Chancroid Syndromic management
• Lymphogranuloma venereum
• Lymphogranuloma Venereum STD Introduction
• Lymphogranuloma Venereum Clinical features
• Lymphogranuloma Venereum Laboratory diagnosis
• Lymphogranuloma Venereum Treatment
• Donovanosis (granuloma inguinale)
• Donovanosis Granuloma Inguinale STD Introduction
• Donovanosis Granuloma Inguinale STD Clinical apperances
• Donovanosis Granuloma Inguinale STD Diagnostic tests
• Donovanosis Granuloma Inguinale STD Treatment

Incubating Syphilis

Incubating Syphilis

The median incubation period is 3 weeks, but it varies from 3 to 90 days. An early spirochetemia develops during this phase, which sets the stage for secondary invasion of virtually every bodily organ.

Primary syphilis

Primary syphilis is characterized by a cutaneous ulcer called a chancre. It is acquired by direct contact with an infectious lesion of the skin or the moist surface of the mouth, anus, or vagina. From 10 to 90 days (average, 21 days) after exposure, a primary lesion, the chancre, develops at the site of initial contact. Chancres are usually solitary, but multiple lesions occur, especially in HIV patients. A primary lesion may be absent. Persons with a history of syphilis may just develop a small papule. Therefore, any genital lesion could by syphilis. Extragenital chancres account for 6% of all chancres, and most occur on the lips and in the oral cavity and are transmitted by kissing or orogenital sex. Other sites include the cervix, perianal area, and anal canal in the female and the perianal area and anal canal in the male homosexual.

The lesion begins as a papule that undergoes ischemic necrosis and erodes, forming a 0.3 to 2.0 cm, painless to tender, hard, indurated ulcer; the base is clean, with a scant, yellow, serous discharge. This is the classic presentation of the hard, clean chancer of syphilis. There is little pain or bleeding when the ulcer is scraped for a darkfield examination.

In contrast, Chancroid presents with a soft, dirty chance with fragile raised borders and exudate at the base.

Regional lymphadenopathy is a constant finding. Enlarged, firm, nonsuppurative, painless lymph nodes appear 1 to 2 weeks after the chancre appears.

Without treatment the chancre heals with scarring in 3 to 6 weeks. Painless vaginal and anal lesions may never be detected. The lymphadenopathy persists after the chancre heals. The differential diagnosis includes ulcerative genital lesions such as chancroid, herpes progenitalis, aphthae in Behet's syndrome, and traumatic ulcers such as occur with biting. If untreated, approximately 25% of the infections progress directly to the second stage, the other 75% enter latency and resolve.

The signs of secondary syphilis may begin before the chancre heals.