. Syphilis : a treatise on etiology, pathology, diagnosis, prognosis, prophylaxis, and treatment . umatic ulcers are usually shallow,often irregular in shape, and are not preceded by subcutaneousnodes. They heal readily under local treatment. LATE CUTANEOUS LESIONS 143 Diffuse Gummous Syphilides In addition to the circumscribed forms of gummata there isalso a diffuse form in which the skin and hjqDoderm are infil-trated to varying degrees of thickness. These lesions are mostcommon upon the limbs and buttocks, but may occur upon anyportion of the skin. There may be but one patch or there maybe
. Syphilis : a treatise on etiology, pathology, diagnosis, prognosis, prophylaxis, and treatment . umatic ulcers are usually shallow,often irregular in shape, and are not preceded by subcutaneousnodes. They heal readily under local treatment. LATE CUTANEOUS LESIONS 143 Diffuse Gummous Syphilides In addition to the circumscribed forms of gummata there isalso a diffuse form in which the skin and hjqDoderm are infil-trated to varying degrees of thickness. These lesions are mostcommon upon the limbs and buttocks, but may occur upon anyportion of the skin. There may be but one patch or there maybe several, and other clinical evidences of syphilis may be pres-ent or absent. In size the lesions vary from a diameter of oneinch to very extensive patches, that may be over a foot in diam-eter. The edge may be either sharply or poorly defined, but isalways convex. The color varies from a pale pink to a deep pur-plish red. There may be no ulceration, which is the more com-mon form, or the entire area or portions of it may be the site ofulcerations. Eventually the whole patch may break down. The. Fig. 71.—Diffuse subcutaneous infiltrations frequently end in localized ulcerations. configuration of the lesions may be circular, oval, serpiginous orirregular. At times an elephantiasis may result. The infiltra-tion is the chief aid in the diagnosis where no ulceration , various other skin diseases must be differentiated, nota-bly psoriasis, eczema, erythema perstans, Bazins disease, lupuserythematosus and the psoriaform type of lupus vulgaris. Lep-rosy also may be simulated. All of these can be excluded by therules already laid down. The pathology of the gummous lesions has been well describedby Fordyce, who states: The gumma comprises the dermathroughout its entire extent with marked vascular changes, adiffuse infiltration and necrotic foci. Viewed with low power,there was apparently a decrease in the number of blood vessels, 144 SYPHILIS but on careful examination i
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectsyphilis, bookyear192
