Syphilis is transmitted from person to person by direct contact with a syphilitic sore, known as a chancre. Chancres can occur on or around the external genitals, in the vagina, around the anus , or in the rectum, or in or around the mouth. Transmission of syphilis can occur during vaginal, anal, or oral sex.

How does a chancre form?

The classic chancre, which develops at the site of inoculation, begins as a painless papule. It quickly erodes, becomes indurated, and forms an ulcer with a clean base. Multiple ulcers can occur. However, 60% of lesions that occur are described as atypical, and the absence of a primary skin lesion is also common.

What does syphilis look like in the beginning?

This stage usually starts with a rash on one or more areas of your body. The rash can show up when your primary sore is healing or several weeks after the sore has healed. The rash can look like rough, red, or reddish brown spots on the palms of your hands and/or the bottoms of your feet.