Quotation from: Manual of Surgery

Written by: Alexander Miles and Alexis Thomson


_Gummatous Infiltration of the Skin_ ("Syphilitic Lupus").--This is a
lesion, met with chiefly on the face and in the region of the external
genitals, in which the skin becomes infiltrated with granulation tissue
so that it is thickened, raised above the surface, and of a brownish-red
colour. It appears as isolated nodules, which may fuse together; the
epidermis becomes scaly and is shed, giving rise to superficial ulcers
which are usually covered by crusted discharge. The disease tends to
spread, creeping over the skin with a serpiginous, crescentic, or
horse-shoe margin, while the central portion may heal and leave a scar.
From the fact of its healing in the centre while it spreads at the
margin, it may resemble tuberculous disease of the skin. It can usually
be differentiated by observing that the infiltration is on a larger
scale; the progress is much more rapid, involving in the course of
months an area which in the case of tuberculosis would require as many
years; the scars are sounder and are less liable to break down again;
and the disease rapidly yields to anti-syphilitic treatment.

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