Patients with stage II syphilis in women usually first present with systemic symptoms, such as mucosal spots on the lips, mouth, tonsils, and throat in some patients. Syphilitic alopecia may also occur, appearing as worm-like or, rarely, diffuse. Some patients may present with damage to the bones and joints, with manifestations such as osteochondritis, osteitis, and arthritis. Ocular syphilis can present with syphilitic iritis, iridocyclitis, and chorioretinitis, and usually presents with bilateral changes. If neurologic syphilis is present, patients will have abnormalities of the cerebrospinal fluid and may have symptoms of meningitis or meningeal vascularization. Some patients will develop generalized superficial lymph node enlargement, after which the patient will develop a typical syphilis rash.