Fissures often develop about the lips and anus. They bleed readily and heal with scarring. White mucous patches may be found on any of the mucous membranes. Late manifestations of congenital syphilis are the result of scarring from the early systemic disease and include involvement of the teeth, bones, eyes, and gummas in the viscera, skin, or mucous membranes. Characteristic changes of the teeth include a notched appearance on the biting edges of the upper central incisors, these are called Hutchinson's teeth.
Interstitial keratitis is the most common late lesion.
Bony changes include sclerosing lesions, saber shin, frontal bossing and gummatous or destructive lesions within long bones. The characteristic symptoms provide a strong clue to the diagnosis, which can be confirmed by the examination of a sample from a tissue sample and antibody tests. However, the diagnosis of congenital syphilis in neonates is complicated by the transfer of maternal IgG antibodies to the foetus across the placenta. This transfer of antibodies makes the interpretation of reactive serologic tests for syphilis in infants difficult. Adequacy of maternal treatment.