Tertiary syphilis is usually not apparent clinically until many years after the spontaneous clearing of the secondary stage. Tertiary syphilis occurs in many clinical syndromes, most conveniently divided into three main groups: neurosyphilis, cardiovascular syphilis and late benign syphilis. The typical lesions of this stage are known as gummas. They are granulomatous, often ulcerative lesions that may affect skin, soft tissue, or bones anywhere and, if left untreated, can permanently destroy the affected tissue. Some of the most dramatic examples occur in the cardiovascular, central nervous, or musculoskeletal systems.
There may be an interval of 1 to over 20 years from the acute infection to clinical onset of the late or tertiary stages of disease, long after the lesions of early syphilis have been forgotten. Studies in the preantibiotic era suggested that about one-third of untreated infections were followed by tertiary complications, of which neurosyphilis was most common, but gummas and cardiovascular disease were also prevalent. Back to syphilis from tertiary syphilis