Syphilis Tertiaria -- Syphilis ulcero-serpiginosa

The ulcerative tendency of a tubercular syphilid may exist from the earliest appearance of the lesion or show itself only after a group or patch of tubercles has formed and lasted for some time. The ulceration may be deep or shallow and may attack all or only a few of the tubercular lesions, so that in some patches both tubercles, ulcers, and crusts are present.

The ulcers travel slowly across the skin by healing and scarring at one margin and advancing at the other. The scars are soft and at first brownish red, later white, except on the legs, where the pigmentation may be permanent. The only subjective symptom is occasional slight tenderness.

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