Secondary syphilis is characterized by the following except -
Occurs 6-8 weeks after development of chancre
Painful and itchy maculopapular lesions
Constitutional features are present
Meningitis, hepatitis, glomerulonephritis and uveitis may occur
The protean manifestations of the secondary stage usually include mucocutaneous lesions and generalized nontender lymphadenopathy. The skin rash consists of macular, papular, papulosquamous, and occasionally pustular syphilides; often more than one form is present simultaneously. The eruption may be very subtle, and 25% of patients with a discernible rash may be unaware that they have dermatologic manifestations. Involvement of the hair follicles may result in patchy alopecia of the scalp hair, eyebrows, or beard in up to 5% of cases. Constitutional symptoms that may accompany or precede secondary syphilis include sore throat (15-30%), fever (5-8%), weight loss (2-20%), malaise (25%), anorexia (2-10%), headache (10%), and meningismus (5%). Acute meningitis occurs in only 1-2% of cases. Less common complications of secondary syphilis include hepatitis, nephropathy, gastrointestinal involvement (hyperophic gastritis, patchy proctitis, or a rectosigmoid mass), ahritis, and periostitis. (Harrison's Principles of internal medicine, 20th edition, page 1382)
Infection