From the Guidelines
No, condylomata lata do not erupt at the site of inoculation in syphilis. These lesions are characteristic of secondary syphilis and appear after the infection has spread systemically, typically 2--8 weeks after primary inoculation, as noted in the guidelines for prevention and treatment of opportunistic infections in HIV-infected adults and adolescents 1. Condylomata lata are flat, moist, papular lesions that commonly develop in warm, intertriginous regions, and might resemble papilloma virus infection 1. The site of inoculation in primary syphilis is instead marked by a chancre, which is a painless, firm, clean-based ulcer with indurated edges. Key characteristics of secondary syphilis include:
- Macular, maculopapular, papulosquamous, or pustular skin lesions, usually beginning on the trunk and spreading peripherally, involving palms and soles
- Generalized lymphadenopathy and fever, malaise, anorexia, arthralgias, and headache
- Condyloma lata, moist, flat, papular lesions in warm intertriginous regions The progression from primary to secondary syphilis represents the dissemination of Treponema pallidum spirochetes throughout the body via the bloodstream and lymphatics, resulting in the widespread cutaneous and systemic manifestations characteristic of secondary syphilis, as described in the guidelines 1.
From the Research
Condylomata Lata in Syphilis
- Condylomata lata are a type of lesion that occurs in secondary syphilis, typically presenting as moist, flat, or raised lesions in the genital and perineal regions 2, 3.
- These lesions can also occur in other areas, such as the oropharynx, and are often associated with a high load of Treponema pallidum, the bacterium that causes syphilis 3.
- The diagnosis of condylomata lata is typically made through a combination of clinical examination, serologic testing, and dark-field microscopy of lesion specimens 4, 5.
- Treatment of condylomata lata involves the use of parenterally administered penicillin G, which is considered the first-line therapy for all stages of syphilis 4, 6.
Site of Inoculation
- The available evidence does not specifically address whether condylomata lata erupt at the site of inoculation in syphilis.
- However, it is known that the primary lesion of syphilis, known as a chancre, typically occurs at the site of inoculation 4.
- Condylomata lata, on the other hand, are a manifestation of secondary syphilis and can occur in various locations, including the genital and perineal regions, as well as other areas such as the oropharynx 2, 3, 5.
Clinical Characteristics
- Condylomata lata are often characterized by their moist, flat, or raised appearance, and can be associated with other symptoms of secondary syphilis, such as fever, lymphadenopathy, and rash 4, 3.
- The lesions can be highly infectious, with a high load of Treponema pallidum, and can respond well to treatment with penicillin G 3, 5.
- The diagnosis and management of condylomata lata require a combination of clinical examination, serologic testing, and dark-field microscopy of lesion specimens, as well as prompt treatment with penicillin G 4, 6.