Diseases of the skin / by J. Ferguson Smith.

  • Smith, J. Ferguson.
Date:
[between 1900 and 1920]
Catalogue details

Licence: In copyright

Credit: Diseases of the skin / by J. Ferguson Smith. Source: Wellcome Collection.

    74/92 page 70
    They are of two main types, the nodular and the gummatous. The nodular tertiary syphilide makes its appearance as an infiltration in the corium, which bears some resemblance to the nodule of lupus vulgaris, but is in general larger, less distinctly yellow when examined with the pressure-glass, and more prone to confluence. The developed lesion is a red, irregularly-shaped patch, sometimes sharply defined, but often with outlying nodules. It is not uncommonly annular, and it is characteristic of it to heal in one part, v/hile extending in another. The scar is thin and papery, but sound and free from nodules. The amount of ulceration is very variable, being on the whole more than that associated v/ith lupus vulgaris. The spread of the lesion is fairly rapid as a rule, but occasional cases of great chronicity are seen. There is as a rule comparatively little tissue-destruction, and when healing has been induced by treatment, the resulting scar is often slight. The gummatous tertiary appears as a node in the hypoderm, and enlarges so as to involve the skin. It breaks down and ulcerates, and may result in very great destruction of tissue, involving cartilage and bone. It is often solitary, but may be multiple. The ulcer produced is typical, having steep, pun,ched-out sides, and a greyish, unhealthy-looking base. Trauma often determines the site of the lesion. On healing it leaves a thin, depressed scar, which is often pigmented. In addition to these two types of lesion syphilis may modify lesions due primarily to some other cause, as, for example, varicose ulcers, which may remain definitely of their own type, but which refuse to heal until specific treatment is instituted. In some gummatous lesions, especially on the hips, thighs, and legs, there are abundant heaped-up crusts, v/hich may at first sight suggest psoriasis, but which conceal typical ulcers. This form is known as rupia. In late tertiary syphilis the tongue may show an irregular thickening of its epithelium, which is v/hitish, from maceration. There is also infiltration in the submucous laver, and sometimes ulceration. This condition is known as leukoplakia, and is an important precursor of cancer. What is the Etiology of Syphilis ? It is caused by the organism called by its discoverer, Schaudinn, spirochaeta pallida, and now generally called
    digitised image 1
    digitised image 2
    digitised image 3