What should you know about syphilis feet?

A syphilis rash may involve the soles of the feet and can occur with changes elsewhere on the body. It may not itch, and the infection can also cause a painless sore earlier in its course. Skin changes can fade without treatment while the infection remains in the body, so improvement does not prove that it has cleared. Many other conditions, including irritation, eczema, fungal infection, or a pressure injury, can affect the feet too.

Arrange a confidential medical assessment if you have a new unexplained foot rash, a painless sore, or a recent sexual exposure that concerns you. Tell the clinician about symptoms in the mouth, genitals, or anus, new partners, and any previous syphilis diagnosis. Testing may involve a blood sample and assessment of a sore when present. If syphilis is diagnosed, take the prescribed antibiotic treatment exactly as directed and discuss testing or treatment for partners. Avoid sexual contact until a clinician explains when it is safe to resume it.

Seek prompt medical care for a new painless sore, a widespread rash, fever, swollen glands, or symptoms after sexual contact with a person who has syphilis. Seek urgent help for eye pain or vision changes, hearing changes, severe headache, weakness, confusion, or difficulty walking, because syphilis can sometimes involve the eyes, ears, or nervous system. Pregnancy also makes prompt testing especially important.

Could this foot finding fit syphilis or another skin condition? Which tests are appropriate now, and could testing need repeating? If treatment is needed, how will follow-up show that it worked? Should current or recent partners be contacted?