. Diseases of children. blebs. Sometimes the contentsof the vesicles become piuulent, but this occurrence is rare, andusually accompanies only the more severe types of infection. Pustular Syphilides.—This type follows the papular eruption. Insome cases the pustules may be seen at birth, in others they may not SYPHILIS 741 manifest themselves for a long time after the initial syphilid. Theseverity of the infection influences their character. They usuallyappear on the face, hands, soles, thighs, scalp, and buttocks. At timesthe eruption may assume the form of impetigo, acne, or ecthyma. Asa rule
. Diseases of children. blebs. Sometimes the contentsof the vesicles become piuulent, but this occurrence is rare, andusually accompanies only the more severe types of infection. Pustular Syphilides.—This type follows the papular eruption. Insome cases the pustules may be seen at birth, in others they may not SYPHILIS 741 manifest themselves for a long time after the initial syphilid. Theseverity of the infection influences their character. They usuallyappear on the face, hands, soles, thighs, scalp, and buttocks. At timesthe eruption may assume the form of impetigo, acne, or ecthyma. Asa rule, the pustular eruption produces permanent scars, and mayresult in extensive skin destruction should it be complicated bycellulitis and gangrene. Bullous Syphilides.—This form, also known as pemphigus, generallymakes its appearance on the soles of the feet and the toes, the palmsof the hand and the fingers, and the limbs. The eruption consists ofblebs which are filled with a clear, turbid, or bloody fluid, are sur-. FiG. 73.—Inherited syphilis in a child two months old. rounded by a slight areola on a base of reddish skin, and have atendency to coalesce. The presence of such an eruption, together withlessened elasticity of the skin (because of a lack of subcutaneous fat),and a look of old age, should make one extremely suspicious of syphilis,particularly if the child is hoarse and has the snuffles. Tubercular and Gummatous Syjjhilides.—^These lesions may occurat any age, but more often between puberty and the thirtieth may be either ulcerative or dry in type, and usually appearfirst upon the face and the anterior surface of the legs in the form ofdull reddish infiltrations which are painless, gradually increase in size,eventually ulcerate, and become encrusted. When ulceration does not 742 THE SPECIFIC INFECTIOUS DISEASES occur, atrophic areas remain, whereas cicatrices which frequentlyproduce marked deformities result from the ulcerative form. Mucous Membrane
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