cowie
cn Steenttens
in leg =
0.3 to 1.0 cm. slightly raised nagenta or purple, circular lesions, which were
not tender.
The heir on the head was closely cropped and over the cranial
vault was seen a large stellate shaped cracking of the skin of the scalp, the
center of this star being a lesion approximately three centimeters by two and one
half centimeters covered by a raised golden flaked discharge,
The branches
running out from this center were covered with a similar taterial.,
area was tender and poggy.
This entire
Over the wrists, on both hands, and also at the base
of the toenails were small colorless to purple vesicles on a red background,
On the base of the left thumb, dorsal surfece, there was an ulceration about 2.5
centimeters by 2 centimeters covered by what appeared to be normal granulation
tissue.
There were many discreet firm nontender lymph nodes in the cervical,
axillary, epitrochlear, and inguinal lymphatic chains,
The left ear was de~-
scribed above and in the left auditory canal was a vurulent sanguinous discharge.
The sclerae were muddy,
There was a slight injection of the conjunctivae.
fundi revealed increased perivascular sheathing of the arteries,
The
In the neso-
pharynx there were no petechiae. The tonsils were moderately enlarged.
corners of the mouth were cracked, crusted and bled on slightest touch.
The
On the
chest wali at the junction of the sternum end the second rib on the left was
a cyst—like mass lying beneath an acne scar,
was not enlarged,
quality,
The lungs were clear,
The rate and rhythm were regular.
‘The sounds were of good
There was a grade II systolic murmur @2t the apex and along the left
sternal border in the fourth and fifth interspaces,
muscled,
The heart
The abdomen was well
The liver was down two finger breadths (3 centimeters) below the costal
sargin in the mid-clavicular line; it was nontender,
The spleen edge could