In secondary syphilis, which skin finding is classically observed?

• A. Maculopapular rash involving the palms and soles
• B. Painless ulcer that heals spontaneously
• C. Vesicular rash on the trunk
• D. Purpuric lesions limited to the extremities

Answer: (A)

The key idea is that secondary syphilis produces widespread skin involvement because the infection has disseminated through the body. The classic skin finding is a diffuse maculopapular rash that characteristically involves the palms and soles, and it is often non-pruritic. This stage may also include mucous patches, condylomata lata, fever, malaise, and generalized lymphadenopathy, reflecting systemic spread.

Thinking about the other options: a painless ulcer that heals spontaneously is the chancre seen in primary syphilis, not secondary. A vesicular rash on the trunk might suggest varicella or a herpes-related eruption, not the typical secondary syphilis pattern. Purpuric lesions limited to the extremities aren’t the hallmark of secondary syphilis and would point more toward vasculopathies or other conditions.