Syphilis Secundaria -- Condylomata lata

In moist, warm regions, especially where the skin is subjected to more or less friction -- that is, where there are opposed surfaces as about the genitals and anus, between the toes, at the angles of the lips and between pendulous breasts -- syphilitic papules usually become macerated, softened and abraded. At first they have a brownish-red, raw appearance, but later the branny scaling which sometimes characterizes the dry lesions may be replaced by a gray pseudo-membrane. Where friction is greater, contiguous patches coalesce and a pimply overgrowth occurs which gives the surface an irregular, warty, or even cauliflower-like formation. Such vegetations may cover considerable surface and sometimes completely surround the anus or vulva. There is usually much excretion of pus which, together with the macerated epithelium, may give rise to a very offensive odor. The excretion is rich in spirochetes and therefore highly infectious.

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