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In tertiary syphilis, gummas are one of the hallmark manifestations. These are soft, tumor-like growths that can occur in various tissues of the body, particularly in the skin, bones, and organs. Gummas result from a chronic inflammatory response due to the presence of the Treponema pallidum bacterium, the causative agent of syphilis. They can be destructive and may lead to serious complications if not treated.

The other manifestations associated with syphilis occur in earlier stages of the disease. A chancre is a characteristic sore associated with primary syphilis. Alopecia is not specifically linked to syphilis and can occur due to various causes, while condylomata lata are fleshy growths seen in secondary syphilis. Therefore, gummas distinctly represent a late, severe complication of the disease, clearly defining tertiary syphilis.