The essentials of diagnosis are the same as in secondary syphilis.

The lesions of secondary syphilis heal spontaneously, but secondary syphilis may relapse if undiagnosed or inadequately treated. These relapses may include any of the findings noted under secondary syphilis: skin and mucous membrane, neurologic, ocular, bone, or visceral. Unlike the usual asymptomatic neurologic involvement of secondary syphilis, neurologic relapses may be fulminating, leading to death. Relapse is almost always accompanied by a rising titer in quantitative serologic tests; indeed, a rising titer may be the first or only evidence of relapse. About 90% of relapses occur during the first year after infection.

Treatment is as for primary syphilis unless central nervous system disease is present.