In osteopathic practice syphilis is not a common disease. The
occurrence of syphilis of the nose is still more rare but certainly
should be recognized.
=Diagnosis.=—The local lesions of the nose are of two types, those of
acquired syphilis and of congenital syphilis.
There are three characteristic manifestations of acquired syphilis
as follows. The primary lesion or hard chancre is a firm, indurated
ulcerated mass with only slight discharge. Chancre of the nose is
exceedingly rare. In secondary syphilis there is the mucous patch, the
result of mucous membrane necrosis. In tertiary syphilis the local
lesion is the gumma or more commonly, the ulceration left from necrosis
of the gumma. These lesions may appear from a few to many years after
the initial infection, but they never follow immediately. The lesions
may appear on almost any part of the intranasal structures. They
resemble the lesions of atrophic rhinitis but in atrophic rhinitis
there is never the extent of destruction that so frequently results
from tertiary syphilis.
=Treatment.=—It has been my practice to refer all suspected cases to
Dr. F. J. Stewart for differential diagnosis and treatment and his
method of the use of salvarsan has proven efficient.