This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: ENT
About nasal syphilis the following is true, except: 
Select and explain. 
A. Perforation occurs in septum, B. Saddle nose deformity may occur, C. In newborn, it presents as snuffles, D. Secondary syphilis is the common association
D: Secondary syphilis is the common association
Answer: D: Secondary syphilis is the common association 
Explanation: Nasal syphilis may be: Acquired: Primary, e.g. chancre in vestibule Secondary, e.g. simple rhinitis, crusting and fissuring leading to atrophic rhinitis Teiary, e.g. Gumma leads to septal perforation and saddle nose deformity (due to collapse of nasal bridge) Congenital: Early (first 3 months): Presenting as snuffles, purulent nasal discharge, fissuring excoriation. Late (around pubey): Gumma in septum and other stigmatas. Teritary syphilis is a common association: primary and secondary syphilis are rare association in nasal syphilitis. Septal perforation occurs in bony pa in case of syphilis.