In _hereditary infantile syphilis_, the prognosis is always uncertain: the more distant from the time of birth the manifestations appear the more favorable usually is the outcome.
#How is cutaneous syphilis to be treated?#
Always with constitutional remedies; and in the graver eruptions, and especially in those more or less limited, with local applications also.
#What constitutional and local remedies are commonly employed in cutaneous syphilis?#
_Constitutional Remedies._--Mercury and potassium iodide; tonics and nutrients are necessary in some cases.
_Local Remedies._--Mercurial ointments, lotions and baths, and iodol in ointment or in (and also calomel) powder form.
#Give the constitutional treatment of the earlier, or secondary, eruptions of syphilis.#
In secondary or early eruptions mercury alone in almost every case; with tonics, if called for. If mercury is contraindicated (extremely rare), potassium iodide may be substituted.
#How is mercury usually administered in the eruptions of secondary syphilis?#
By the mouth, chiefly as the protiodide, calomel and blue mass, in dosage just short of mild physiological action; by _inunction_, in the form of blue ointment; by _hypodermic injection_, usually as corrosive sublimate solution. The method by _fumigation_, with calomel or bisulphuret, is now rarely employed.
The method by the mouth is the common one, and it is only in rare instances that any other method is necessary or advisable.
#What local applications are usually advised in the eruptions of secondary syphilis?#
If the eruption is extensive, and more especially in the pustular types, baths of corrosive sublimate ([dram ii-dram-iv] to Cong. xxx) may be used; and ointment of ammoniated mercury, twenty to sixty grains to the ounce, blue ointment, and the ten per cent. oleate of mercury alone or with an equal quantity of any ointment base.
The same applications or a dusting powder of calomel may also be used on moist papules.
#How long is mercury to be actively continued in cases of early (secondary) syphilis?#
Until one or two months after all manifestations (cutaneous or other) have disappeared, and then, as a general rule, continued, as a small daily dose (about one-quarter to one-third of that prescribed during the active treatment) for a period of two or three months; then another cycle of the active dosage for a period of four to six weeks; then a resumption of the smaller daily dose for another two or three months; and so on, for a period of at least two years.