A system of surgery . year, and by some twoyears from the date of infection is given as the limit of time duringwhich secondary symptoms may appear. On the whole, the latterappears to be the most accurate and convenient, with the reservationthat there is no sharp line of distinction between the secondary andtertiary stages. Skin eruptions.—The most frequent early syphilitic eruption 394 SYPHILIS takes the form of—(1) an erythema or roseola, consisting ofscattered pinkisli spots on the trunk and limbs (especially the flexoraspects), which diminish or disappear on stretching the skin, andwhich a
A system of surgery . year, and by some twoyears from the date of infection is given as the limit of time duringwhich secondary symptoms may appear. On the whole, the latterappears to be the most accurate and convenient, with the reservationthat there is no sharp line of distinction between the secondary andtertiary stages. Skin eruptions.—The most frequent early syphilitic eruption 394 SYPHILIS takes the form of—(1) an erythema or roseola, consisting ofscattered pinkisli spots on the trunk and limbs (especially the flexoraspects), which diminish or disappear on stretching the skin, andwhich are not unlike the eruption of measles. Next in frequency and order of appearance comes (2) apapular or lichenoid syphilide. This may consist of eithersmall or large papules, which are composed of masses of exudationcells, accompanied by congestion and alteration of the walls of thesmall vessels in and close to the papules (thickening of the coats andcell deposit around them). A certain amount of proliferation and. Pig. 79.—Condyloma at the Margin of the Anus, from a patient with secondary surface of the condyloma is seen to be intersected by fissures, and to have asomewhat granular appearance. inflammatory change is common in the epithelium covering thepapules, and hence there may be a thin dry scale on each, formingthe papulosquamous syphilide. The large papules are of the samenature, and if desquamation occurs on them, a mere or less closeresemblance to common psoriasis is produced. If situated on partsof the skin habitually moist, such as the scrotum, the vulva, aroundthe anus, and at the lip-commissures, these large papules have a peculiarappearance, becoming covered with a delicate whitish kind of falsemembrane, secreting a thin discharge (which is extremely liable toconvey infection to others), having a broad base and a smoothsurface. They are then known as condylomata; and very similarlesions occur on the mucous membrane of the mouth lining the lips,th
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