. The ready-reference handbook of diseases of the skin. rm a general eruption. The diagnosis of this form of syphilide is usually readilyarrived at by finding other symptoms of syphilis. Occasion-ally it may be confounded with lupus vulgaris and leprosy. SYPHILIS. 497 From lupus it is differentiated by the comparative rapidityof its course, lupus being a disease of exceeding slownessof development; by its occurrence in mature years, lupusbeing a disease of youth ; by its sharp-cut round ulcers;by its thick greenish crusts, and by the smoothnessof its cicatrices, those of lupus being puckered a
. The ready-reference handbook of diseases of the skin. rm a general eruption. The diagnosis of this form of syphilide is usually readilyarrived at by finding other symptoms of syphilis. Occasion-ally it may be confounded with lupus vulgaris and leprosy. SYPHILIS. 497 From lupus it is differentiated by the comparative rapidityof its course, lupus being a disease of exceeding slownessof development; by its occurrence in mature years, lupusbeing a disease of youth ; by its sharp-cut round ulcers;by its thick greenish crusts, and by the smoothnessof its cicatrices, those of lupus being puckered and de-forming. Syphilis at times bears a striking resemblanceto leprosy when its tubercles are located in the eyebrows,face, and ears, but the absence of anaesthesia is a positivediagnostic sign against leprosy. Moreover, other symptomsof leprosy, such as swelling of the ulnar nerves and pecu-liar brown patches, will be absent. The squamous syphilide is not usually described, as it isa modified form of either the papular or tubercular lesion. Fig. V Squamous serpiginous syphilide. (After Lassar.) In using the term here, I follow my esteemed master, Pro-fessor George H- Fox, and like* him adopt it purely onclinical grounds. He applies thelterm to scaly patches of 498 DISEASES OF THE SKIK circular or irregular form that occur after the first year ofsyphilis. These patches are covered with thin horny scalesseated upon an infiltrated base. We may have one of twoforms : the discoid, or the circinate. The discoid form isalmost peculiar to the palms and soles and neighboringparts, and constitutes the only apparent lesion. The roundpatch of varying size, but with a sharply defined reddishseam beyond the scaling, and an infiltrated base, tends tobecome serpiginous, creeping over a considerable portion ofthe skin. Sometimes while it advances at one border, itheals at the other; at other times it clears up in the center,leaving an elevated, scaling marginal ring. The ring maybe broke
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