The surgical diseases of the genito-urinary organs including syphilis / by E.L. Keyes ; a revision of Van Buren and Keyes's text-book upon the same subjects.

  • Keyes, E. L. (Edward Lawrence), 1843-1924.
Date:
1889, ©1888
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Licence: Public Domain Mark

Credit: The surgical diseases of the genito-urinary organs including syphilis / by E.L. Keyes ; a revision of Van Buren and Keyes's text-book upon the same subjects. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    Diagnosis.—Color, areola, and .slowness of development distin^'uish this eruption from ordinary herpes. 'J.lie circinate form does not pro- gress centrifugally, as do other forms of circinate herpes. 7. Squamous Syphilide.—Nearly all the eruptions of syphilis go through a desquamative stage, and thus a patch of eruption which is essentially papular, tubercular, or pustular may finally become scaly, and, remaining so for a considerable time, pass for a squamous syphi- lide. So also does pityriasis occur in syphilis, as of the scalp with early alopecia; sometimes in little patches along the margin of the scalp with the other syphilides ; again, with syphilitic cachexia, furfuraceous desquamation of the scalp, or even of the whole body, may be encoun- tered, with a dry, rough skin. In none of these cases, however, can it be affirmed that pityriasis is an essentially syphilitic lesion. It is rather a local consequence of general blood deterioration, and may be induced by many causes other than syphilis. There are, however, two varieties of essentially scaly syphilide where the scale is the j)rominent lesion from the first. These are : [a) Generalized squamous syphilide. [h) Palmar and plantar squamous syphilide. {a) Generalized Squamous Syphilide.—This eruption occurs in two varieties—as a guttate or diffused psoriasis, and in the circinate (lep- rous) form. The characters of the eruption are the same in both. They may be met together on the same subject. The patches vary from a split pea to a penny in size—or much larger in the circinate or gyrate form—have (as a rule) the deep syphilitic color, are but slightly elevated above the surface, not papulated. The scales are white, very fine, not adherent, not imbricated (as m true psoriasis). After a few weeks the scales fall. They may be replaced by others, finer than the first, and thus several desquamations occur. Finally, the color pales and the darkened spot disappears, leaving no cicatrix, provided the eruption has not been a mixed one (tuberculo-squamous), which form does leave scar from interstitial absorption. The circinate form starts as a circle, or segment of a circle, inclosing healthy skin, does not generally increase in size, and lasts from a few weeks in the earlier variety to some months in the later, where there is more interstitial thickening of the skin. This eruption does not appear before six months from chancre, and may come on after an interval of many years. It may coexist with other sj^philodermata. Scaly syijhilides, appearing before six months from chancre, are usually the remains of previous papular eruptions. The squamous syphilide appears upon the trunk, the members, the face, and along the forehead at the edge of the hair. It shows no tendency to locate at the elbows and knees, like the non-specific form. The later its appearance after chancre, the longer does it tend to remain. Diagnosis. —ySlhen not associated with other specific lesions, the