It’s possible for a person with syphilis to have sores (chancres) on the hands without visible lesions on the face. Syphilis progresses through stages, and the symptoms vary:
• Primary Syphilis: Typically presents with a painless sore (chancre) at the site of infection, which could be on the hands if the bacteria entered through a cut or abrasion there. Chancres usually heal within a few weeks.
• Secondary Syphilis: Often involves a widespread rash, which can include the palms and soles. These rashes are often reddish or copper-colored but can sometimes present as sores or wart-like growths.

If someone has unexplained sores on their hands, syphilis should be considered as a possibility, especially if there’s potential exposure. A blood test can confirm the diagnosis.