The primary syphilis stage can be indicated by the initial lesion of syphilis which is a papule that appears at the site of contact. Typically it appears 10-90 days with an average of three weeks after initial contract. After a week it ulcerates, but not before growing to a typical size of 0.5-1.5 cm in diameter. This typical chancre of primary syphilis is a round slightly elongated ulcer, 1-2 cm across, with an indurated margin. The ulcer base is clear and free from exudate. The genital ulcer is painless which is a feat in itself due to its size. This painless attribute is part of the natural history of the infection. A sign of infection is a medium enlargement of inguinal lymph nodes, bilaterally in those that have genital marks. Typically solitary lesions are present but multiple lesions frequently occur. Primary lesions will not be typical especially those located in the anal area. Typically a primary syphilitic chancres occur in the genital, perineal or anal area due to their sexual origin; however, any part of the body may be affected. The perineal area is the space between your anus and your genitalia.
The primary chancres are found on the penis of men and the labia, fourchette, or cervix of women. The fourchette is the structure formed from the labia minor that looks like a fork. Fourchette is French for “little fork.” Typically, the diagnoses of syphilis will occur during the primary stage in heterosexual men. With women, diagnoses doesn’t usually come until the secondary syphilitic stage due to the painless chancre not being visible in women. This also applies to chancres in the anus or rectum which are commonly amongst homosexual men. The lesions in the anus or rectum may cause pain and bleeding upon using the bathroom, they go unnoticed because they are mistaken for hemorrhoids or a neoplasm. These go unnoticed like those on the labia and cervix. Without any treatment, the syphilitic chances can heal spontaneously within 3-6 weeks. Back to syphilis from primary syphilis.