. Syphilis : a treatise on etiology, pathology, diagnosis, prognosis, prophylaxis, and treatment . ce and MacKee.) nodules to mark the advancing edge, but in other instances thereis a steady chain of nodules that resemble a chain of beads, vary-ing only in that some are confluent. When the nodules areclose together there is more tendencv lor the formation of either 132 SYPHILIS punched-out ulcers or atrophic scars than when a smaller numberof nodules are present. In all instances the spread is compara-tively slow, it usually taking at least three months for a lesionto reach a diameter of six i
. Syphilis : a treatise on etiology, pathology, diagnosis, prognosis, prophylaxis, and treatment . ce and MacKee.) nodules to mark the advancing edge, but in other instances thereis a steady chain of nodules that resemble a chain of beads, vary-ing only in that some are confluent. When the nodules areclose together there is more tendencv lor the formation of either 132 SYPHILIS punched-out ulcers or atrophic scars than when a smaller numberof nodules are present. In all instances the spread is compara-tively slow, it usually taking at least three months for a lesionto reach a diameter of six inches. While the early lesions ofsyphilis are usually symmetrical, it is unusual for this to be trueof the late ones. Then, too, in the late lesions there is a tendencyfor the syphilides to disappear spontaneously, only to crop up onsome other portion of the body. Pathologically all of the nodular lesions show striking simi-larities. Fordyce^ gives the following description: In the. Fig. 59.—A ciixinate nodular sypliilide may form rings witliin rings. (Collection of Dr. Richard L. Sutton.) nodular or tubercular syphilide the entire cutis from the epider-mis to the subcutaneous fat tissue was involved, under a lowpower showing alternating light and dark areas, the former rep-resenting the altered blood vessels and the latter a cellular ef-fusion. Under the high power the infiltration was composed ofplasma and giant cells, lymphocytes and hyperplastic fibro-blasts. The vessels, increased in number, showed the effects ofan obliterating endarteritis, their former site being marked bysolid cords, groups of irregularly disposed cells with pale stain-ing nuclei and giant cells Avith peripheral or central nuclei orboth. Near the edge of the section were a few vessels with nar-rowed lumina and a hyperplasia of all their coats. A number of LATE CUTANEOUS LESIONS 133 the lymph spaces Avere thrombosed. The few remamiiig bundlesof connective tissue had here and there a vacu
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectsyphilis, bookyear192
