Because of their frequency and early appearance the changes in the bones, especially the femur and humerus, are of diagnostic value. Other symptoms include rhinitis , coryza , or snuffles. Snuffles usually occur in the first week of life, are very persistent and often bloody. A syphilitic rash, typically consisting of small spots that are dark red to copper, usually appears after 1- 2 weeks of rhinitis and is most severe on the hands and feet. As the rash fades, the lesions become coppery or dusky red.
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.