Secondary syphilis. Skin lesions on man's chin. These warty plaque-like lesions are condylomata lata, and are associated with secondary syphilis. Syphilis is an infection by the Treponema pallidum bacterium. The secondary stage usually starts a month after the initial infection, with this rash and also headaches, bone pain and fatigue. When this subsides, the patient appears healthy. The latent stage may last for years, even decades, but can progress to tertiary syphilis with tissue death, blood vessel disease, paralysis, and brain damage. All stages are treated with the antibiotic drug penicillin. Syphilis is usually transmitted during sex. Photographed in Africa.