How would you distinguish the macular syphiloderm from measles, rötheln and tinea versicolor?
Measles is to be differentiated by its catarrhal symptoms, fever, form and situation of the eruption; rötheln, by its small, roundish, confluent pinkish or reddish patches, its precursory pyrexic symptoms, its epidemic nature, and short duration; tinea versicolor by its scaliness, peripheral growth, distribution and history.
And, finally, by the absence or presence of other symptoms of syphilis.
Fig. 51.
Macular Syphiloderm.
What several varieties of the papular eruption of syphilis are met with?
There are two forms of the papular eruption—the small and large; those of the latter type may undergo various modifications.
Describe the small-papular eruption of syphilis.
The small-papular syphiloderm (miliary papular syphiloderm) usually shows itself in the third or fourth month of the disease, and consists of a more or less generalized eruption of disseminated or grouped, firm, rounded or acuminated pin-head to millet-seed-sized papules, with smooth or slightly scaly summits, and in some lesions showing pointed pustulation. Scattered minute pustules and some large papules are usually present. The eruption is profuse, most abundant upon the trunk and limbs; and in the early part of the outbreak is of a bright- or dull-red color, later assuming a violaceous or brownish tint. It runs a chronic course, is somewhat rebellious to treatment, and displays a tendency to relapse.