The syphilitic deposit consists of round-cell infiltration. The mucous layer, the corium, and in the deep lesions the subcutaneous connective tissues also, are involved in the process. The infiltration disappears by absorption or ulceration. The factor now believed to be responsible for the disease and the pathological changes is the Spirochæta pallida, discovered by Schaudinn and Hoffmann, and usually found in numbers in the tissues.
Give the prognosis of cutaneous syphilis.
In acquired syphilis, favorable; sooner or later, unless the whole system is so profoundly affected by the syphilitic poison that a fatal ending ensues, the cutaneous manifestations disappear, either spontaneously or as the result of treatment. The earlier eruptions will often pass away without medication, but treatment is of material aid in moderating their severity and hastening their disappearance, and is to be looked upon as essential; in the late syphilodermata treatment is indispensable. In the large pustular, the tubercular and gummatous lesions, considerable destruction of tissue may take place, and in consequence scarring result. Ill-health from any cause predisposes to a relapse, and also adds to the gravity of the case.
In hereditary infantile syphilis, the prognosis is always uncertain: the more distant from the time of birth the manifestations appear the more favorable usually is the outcome.
How is cutaneous syphilis to be treated?
Always with constitutional remedies; and in the graver eruptions, and especially in those more or less limited, with local applications also.
What constitutional and local remedies are commonly employed in cutaneous syphilis?
Constitutional Remedies.—Mercury and potassium iodide; tonics and nutrients are necessary in some cases.
Local Remedies.—Mercurial ointments, lotions and baths, and iodol in ointment or in (and also calomel) powder form.
Give the constitutional treatment of the earlier, or secondary, eruptions of syphilis.