. Syphilis : a treatise on etiology, pathology, diagnosis, prognosis, prophylaxis, and treatment . Fig. 31.—In lenticular syphilis the lesion may fuse. The lenticular lesions but rarely become squamous. The pathology of these lesions has been studied by Fordyce,Unna, Dennie, Crocker and others, as has already been mentioned,and there is general agreement as to the findings. There is acircumscribed lesion consisting of lymphocytes, plasma cells and EARLY CUTANEOUS LESIONS 107 proliferated fibroblasts which frequently surround the vesselslike a coat sleeve. Giant cells are far from uncommon. The
. Syphilis : a treatise on etiology, pathology, diagnosis, prognosis, prophylaxis, and treatment . Fig. 31.—In lenticular syphilis the lesion may fuse. The lenticular lesions but rarely become squamous. The pathology of these lesions has been studied by Fordyce,Unna, Dennie, Crocker and others, as has already been mentioned,and there is general agreement as to the findings. There is acircumscribed lesion consisting of lymphocytes, plasma cells and EARLY CUTANEOUS LESIONS 107 proliferated fibroblasts which frequently surround the vesselslike a coat sleeve. Giant cells are far from uncommon. Thereis also an endarteritis of many of the vessels. The perivascularinfiltration undoubtedly starts in the perivascular changes in the epidermis are secondary. It may be thinnedfrom pressure of the granuloma beneath, or there may be edemawith an increase in thickness and scaling. These lesions must be diagnosed from papular eczema, psori-asis, lichen planus, scabies and erythema multiforme. The diag-. Fig. 32.—Frambesiform or hypertrophic syphilides are rather unusual. nosis of eczema and psoriasis from syphilitic lesions has alreadybeen discussed. Lichen planus presents angular lesions withfiat tops, that often show umbilication and which shine by re-flected light. In addition they are usually arranged in the later lesions the violaceous color is very is frequently extreme itching. Lesions in the mouthshould always be looked for. The distribution of scabies, themultiform types of lesions and the itching at night should serveto distinguish this disease. It will be recalled that the lesions pre-
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectsyphilis, bookyear192
