Recurrent Tertiary Syphilis. Presented by Dr. Weidman for Dr. White.
Mrs. N. B., aged 60, housewife, was exhibited before this society one year ago with a diagnosis of parapsoriasis lichenoides. At a second observation in August, 1925, the eruption was the same recurrent lichenoid, papular type, over the arms, legs and back, associated with moderate itching. She was treated with potassium iodide and liquor carbonis detergens. Two months later the eruption was nodular, annular or segmental; withal, rather abundant for a late syphilitic manifestation. A Wassermann test was strongly positive. The patient was placed on antisyphilitic therapy—small doses of neoarsphenamine, with subsequent involution of the lesions. Biopsy indicated a granuloma, but a definite diagnosis between tuberculosis and syphilis could not be made from the material examined.
Dr. Stokes: The basis of the diagnosis were the induration and the presence of definite, though atrophic, scarring. The dosage of neo-arsphenamine was