In secondary syphilis, which physical examination finding is most consistent with the diagnosis?

• A. Chancre
• B. Condylomata lata
• C. Condylomata acuminata
• D. Gummas

Answer: (B)

In secondary syphilis, widespread mucocutaneous involvement is typical. Condylomata lata are broad, moist, flat-topped plaques often found in moist areas such as the genitals or perineum. They are highly infectious due to a high load of Treponema pallidum and are a classic finding of the secondary stage.

By contrast, a chancre is the painless ulcer of primary syphilis and appears before secondary disease. Condylomata acuminata are genital warts caused by human papillomavirus, not syphilis. Gummas are granulomatous lesions associated with tertiary syphilis, not secondary. Thus, condylomata lata best fit the presentation of secondary syphilis.