Practical podiatry : . degenerative process to necessitatesurgical interference—perhaps amputation of the foot. Ashas been previouslymentioned, even whenfully healed, relapse al-most always occurs. The Syphilitic syphilitic ulcers donot properly come withinthe province of the podi-atrist for treatment, buthe should be able torecognize them. Theymay develop from pus-tules or begin as originallesions in the tertiarystages of the disease. De-veloping in this latter in-stance from gummata,they are immediatelydeep ulcers. The worst superficialulcers of syphilis maydevelop early in thecour
Practical podiatry : . degenerative process to necessitatesurgical interference—perhaps amputation of the foot. Ashas been previouslymentioned, even whenfully healed, relapse al-most always occurs. The Syphilitic syphilitic ulcers donot properly come withinthe province of the podi-atrist for treatment, buthe should be able torecognize them. Theymay develop from pus-tules or begin as originallesions in the tertiarystages of the disease. De-veloping in this latter in-stance from gummata,they are immediatelydeep ulcers. The worst superficialulcers of syphilis maydevelop early in thecourse of the generaldisease. Symptoms. These ulcers vary in size from a quarterto a silver dollar and occur on the upper third of the leg,occasionally on the upper part of the middle third. Duringthe early stages of the lesion it is surrounded by an inflamedarea of skin at the ulcer and presents an even, punchedout edge. Being a new growth, developed in the corium,the edges are usually more firm and dense than in other. SYPHILITIC ULCER OP THE LEG 328 PODIATRY forms of ulcer. The floor of the lesion is of a dusky red orcoppery color, and has a characteristic slough of a greenishcolor. The discharge is frequently bloody and is filled withbroken down tissue. If on account of the presence of enlarged veins, it isdifficult to distinguish from a varicose or othertype of ulcer, a positive Wasserman test will confirm thediagnosis. Being merely a local manifestation of a general infec-tion, the systemic disturbance must be treated by a licensedphysician. It is generally found that a lesion of this type,once healed, remains so. Treatment. Treatment for syphilitic ulcers compre-hends the use of mercurials as local applications. Mercurybichloride 1/10000 may be employed with beneficent resultsin most cases where a profuse discharge is present. Wherethere is little or no discharge, calomel powder dusted intothe ulcer will give good results. As in most cases where a syphilitic l
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