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September 1938

SYPHILITIC ONYCHIA: Report of Case in Which Ungual Changes Helped to Establish the Diagnosis and the Time of Syphilitic Infection

Author Affiliations

Montreal, Canada

Arch Derm Syphilol. 1938;38(3):432-433. doi:10.1001/archderm.1938.01480150106017

REPORT OF CASE  Mr. I. J., aged 41 years, in general good health, had an irrelevant past and family history. He was first seen because of an ill defined papular eruption on both palms and soles which was undergoing involution. A few papulosquamous lesions suggestive of psoriasis were seen on the extensor surfaces of the elbows. Immediately distal to the lunula of each thumb nail was a single well marked Beau line. The right index finger was slightly lusterless and showed a few fine whitish longitudinal striations. The examination showed no other abnormality. The patient stated that he had had no recent sexual intercourse, no penile lesion and no generalized eruption.

COMMENT  Late secondary syphilis, psoriasis and atypical lichen planus were considered in the differential diagnosis. The ungual changes were nonspecific and might have occurred in either syphilis or psoriasis. The Wassermann reaction was positive, but active psoriasis with

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