The noma is an early cutaneous and mucosal manifestation of syphilis infection, initially appearing as an erythematous spot or papule, which may then progress to a depressed, superficial ulcer. In the early stages of the chancre, the main manifestation is localized erythema and papules. As the disease progresses, the localized erythema or papule may break down and form a round or oval depressed superficial painless ulcer. Swollen lymph nodes in the groin may also be palpable. The hard chancre can occur in areas such as the penis and anus in men and the labia and cervix in women. Syphilis infection can be treated with penicillin of choice under the supervision of a physician. Because syphilis is transmitted by sexual contact, it is recommended that both the patient and sexual partner should go to the hospital at the same time to receive a checkup to avoid delays.