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A Case for Diagnosis (Syphilitic Onychia?). Presented by Dr. Samuel Feldman.
J. F., a shoemaker aged 52, says that he is not aware of having a venereal disease. His wife had no miscarriages. The Wassermann and the Kahn reaction of the blood were 4 plus.
The nails show longitudinal ridges and irregular pitting. The edges are brittle and separated from the nail bed. The nail of the ring finger of the left hand shows a yellowish white area surrounded by a red rim, which is plainly visible through the healthy transparent portion of the nail plate. The entire area appears to be somewhat depressed below the surface of the nail and gives the impression of a circumscribed syphilitic papule. On the anterior surface of the left thigh there is a firm, painless swelling with a deep perforation in the center.
DISCUSSION
Dr. Arthur Sayer: I believe that a diagnosis