Primary syphilis classically presents with which finding?

• A. Painful ulcer at exposure site
• B. Mucous patches
• C. Painless ulcer at exposure site (chancre)
• D. Generalized MP rash on palms/soles

Answer: (C)

Primary syphilis presents with a painless chancre at the site of inoculation. This lesion is a firm, non-tender ulcer with a clean base and indurated borders, often accompanied by regional lymphadenopathy. It typically appears about three weeks after exposure and heals spontaneously within 3–6 weeks if untreated, although the infection may progress to secondary syphilis if not treated. The other findings listed fit later stages or other conditions: a painful ulcer suggests chancroid or herpes, while mucous patches and a generalized rash on the palms and soles are characteristic of secondary syphilis.