deep ulcers, the scar is
depressed and adherent (Fig. 39).

[Illustration: FIG. 39.--Syphilitic Rupia, showing the limpet-shaped
crusts or scabs.]

In the later stages there may occur a form of creeping or _spreading
ulceration of the skin_ of the face, groin, or scrotum, healing at one
edge and spreading at another like tuberculous lupus, but distinguished
from this by its more rapid progress and by the pigmentation of the
scar.

_Condylomata_ are more characteristic of syphilis than any other type of
skin lesion. They are papules occurring on those parts of the body where
the skin is habitually moist, and especially where two skin surfaces are
in contact. They are chiefly met with on the external genitals,
especially in women, around the anus, beneath large pendulous mammae,
between the toes, and at the angles of the mouth, and in these
situations their development is greatly favoured by neglect of
cleanliness. They present the appearance of well-defined circular or
ovoid areas in which the skin is thickened and raised above the surface;
they are covered with a white sodden epidermis, and furnish a scanty but
very infective discharge. Under the influence of irritation and want of
rest, as at the anus or at the angle of the mouth, they are apt to
become fissured and superficially ulcerated, and the discharge then
becomes abundant and may crust on the surface, forming yellow scabs. At
the angle of the mouth the condylomatous patches may spread to the
cheek, and when they ulcerate may leave fissure-like scars radiating
from the mouth--an appearance best seen in inherited syphilis (Fig. 44).

_The Appendages of the Skin._--The _hair_ loses its gloss, becomes dry
and brittle, and readily falls out, either as an exaggeration of the
normal shedding of the hair, or in scattered areas over the scalp
(_syphilitic alopoecia_). The hair is not re-formed in the scars which
result from ulcerated lesions of the scalp. The _nail-folds_
occasionally present a pustular eruption and superficial ulceration, to
which the name _syphilitic onychia_ has been applied; more commonly the
nails become brittle and ragged, and they may even be shed.

_The Mucous Membranes_, and especially those of the _mouth_ and
_throat_, suffer from lesions similar to those met with on the skin. On
a mucous surface the papular eruption assumes the form of _mucous
patches_, which are areas with a congested base covered with a thin
white film of sodden epith