Page:Skin Diseases of Children.djvu/121



Syphilis hereditaria.—When syphilis is transmitted from one generation to another it may result in the death of the foetus in utero, or in the development of an infantile eruption which either is present at birth or appears shortly after. In most cases it manifests itself within three months, and always during the first year. The eruption may be erythematous and appear as a general roseola, similar to the earliest eruption of acquired syphilis, or in the form of dull-red patches on the trunk and upon the palms and soles, which present a dry, scaly appearance quite characteristic of the inherited disease. About the mouth the skin is often dry and fissured, and on the buttocks the patches are apt to become raw and even ulcerated at various points. In some cases the eruption assumes a papular character (see plate), and numerous yellowish-red and slightly scaly discs are seen upon the buttocks, thighs, and face, and occasionally over the greater portion of the body. In rare instances the papules are small, flattened, and shining, and present a strong resemblance to lichen planus. Pustular lesions of an ecthymatous character are sometimes present, especially in infants who are ill-nourished and poorly cared for. Bullous lesions are not infrequently seen upon the palms and soles and other portions of the body, and in fact are much more common than in the acquired disease of adult life.

In connection with these early cutaneous manifestations a notable condition of malnutrition is usually observed, and certain characteristic symptoms resulting from affection of the mucous membranes and the osseous structures. The nasal passages are often inflamed and obstructed by an accumulation of mucus. The larynx may be affected, giving rise to a peculiar hoarse cry.

The prevention of hereditary syphilis is more important than