Patients may usually develop symptoms 7-60 days after infection with syphilis. The first symptom is a hard chancre, which can appear on the patient’s penis, glans, coronal prepuce, urethra, labia majora and minora, clitoris, cervix, anus, and anal canal. The ulcers can be single, round or oval, with clear borders, raised above the skin surface, with a clean wound and increased discharge secondary to infection. The enlarged lymph nodes may be single or multiple, of different sizes, with a tough texture, and are usually painless.