Variations in the reaction of persons to syphilitic infection have caused much speculation. Fifty years ago Fournier emphasized the impossibility of predicting the course of a syphilitic infection. Even today we can offer a prognosis only on the basis of efficient treatment.
Quoting Krause,1 "two really fundamental factors can possibly have an influence on disease. These are inheritance, or the nature and activities of tissues as born into the world; and environment, which includes every mundane experience which, directly or indirectly, may have an effect on the constitution and function of tissues."
Inheritance probably explains in part certain differences in tissue reactions in syphilis, such as the early development of allergy in syphilis maligna, and the apparent absence of such a process in syphilis secondaria tarda. Inherited differences may have a determining influence on the localization of syphilitic lesions in various tissues or on the character which these processes
ZIMMERMANN EL. A COMPARATIVE STUDY OF SYPHILIS IN WHITES AND IN NEGROES. Arch Derm Syphilol. 1921;4(1):75–88. doi:10.1001/archderm.1921.02350200078008
Dermatology in JAMA: Read the Latest
Customize your JAMA Network experience by selecting one or more topics from the list below.