January/February 2012 • Volume 10 • Issue 1 - SKINmed Journal

January/February 2012
26 Rothschild C, Rothschild BM. Patterns of periosteal reaction in England
from Roman through Elizabethan epochs. J Paleopath 1995;7:130.
27 Rothschild BM. History of syphilis. Clin Infect Dis. 2005;40:1454–1463.
28 Pearce JMS. A note on the origins of syphilis. J Neurol Neurosurg Psychiatry.
1998;64:542.
29 Di Cicco CO. History of syphilis. J Eur Acad Dermatol Venereol.
2005;19:1–11.
30 Dutour O, Palfi G, Berato J, Brun JP. The Origin of Syphilis in Europe: Before
or After 1493? Toulon: Centre Archéologique du Var; 1995.
31 Stirland, A. Evidence for pre-Columbian treponematosis in Medieval Europe.
In: L’Origine de la Syphilis en Europe Avant ou après 1493? Dutour
O, Palfi G, Berato J, Brun JP, eds. Toulon, France: Centre Archéologique
du Var; 1995:109–115.
32 Anderson T, Arcini C, Anda S, Tangerud A, Robertsen G. Suspected
endemic syphilis (treponarid) in sixteenth-century Norway. Med Hist.
1986;30:341–350.
33 Virchow RLK. Beitrag zur geschichte der lues. Arch Dermatol. 1896;2:1–9.
34 Lahr MM, Bowman JE. Palaeopathoogy of Kechipawan Site: health and
disease in a south western pueblo. J Archeolog Sci. 1992;19:639–654.
35 Roberts C, Millard A, Pearson G, Macpherson C, Nowell G. The origin
and mobility of people with venereal syphilis buried in Hull, England in
HISTORICAL DIAGNOSIS & TREATMENT: SYCOSIS (continued from page 7)
SYNONYMS: ACNE SYCOSIS; SYCOSIS BARBAE, SEU MENTI;
SYCOSIS NON PARASITICA; MENTAGRA; FOLLICULITIS
BARBAE, SEU PILORUM.
Sycosis is a chronic inflammatory disease of hairy parts of the
skin characterized by tubercles, papules and pustules, each of
which is pierced invariably by the shaft of a hair. In the great
majority of cases the disease is limited to the region of the
beard in men, though it may occur on the eyebrows, scalp,
axillae and pubes. On the face it starts usually as one or more
ill defined patches and may remain confined in certain areas or
spread so as to include in time the whole bearded region. The
disease does not extend to non-hairy parts. The lesions may
be discrete and relatively few in number, or, in very severe
cases, so numerous and closely set as to form almost continuous
patches of infiltration. The inflammation starts in the walls
of the hair follicles and the first surface manifestations are papules
or tubercles situated at the orifices, with a hair passing
through each little elevation. The papules and tubercles soon
change into pustules. Occasionally in old patches, pustules
develop about the hairs without preceding papulation. The pustules
exhibit slight tendency to rupture, but the inflammatory
exudate often escapes alongside the hairs from the mouths of
the follicles and dries to form small crusts. When the lesions
are closely set one crust may cover the openings of several
follicles. The removal of such a crust does not expose a raw,
oozing surface, but tears the top off a number of pustules. The
amount of crusting is never very great. Burning and tension are
usually the only subjective symptoms complained of. At the onset
of an attack traction on the hairs which issue from inflamed
follicles causes considerable pain, but later the root sheaths
become swollen with pus and the hairs loosen and may be
easily extracted. At times they fall out spontaneously. The hair
loss is seldom permanent, though in some cases the thinning
SKINmed. 2012;10:8–12
12
COMMENTARY
the late medieval period. Poster presented at: the 18th Paleopathology
Association European Meeting, Vienna, Austria; 2010.
36 Rothschild BM. History of syphilis. Clin Infect Dis. 2005;40:1454–1463.
37 Henneberg RJ, Henneberg M. Possible occurrence of treponematosis
in the ancient Greek colony of Metaponto. Am J Phys Anthropol. 1995
(suppl 163):107–108.
38 Efremov IA. Taphonomy: a new branch of paleontology. Pan-Am Geol.
1940;74:81–93.
39 Columbus Didn’t Sail Syphilis Back to Europe. Medieval Archives Illuminating
the Dark Ages for the Digital World. Sci Technol. Oct 27, 2010.
40 Hudson EH. Treponematosis and man’s social evolution. Am Anthropol.
1965;67:885–901.
41 Gray RR, Mulligan CJ, Molini BJ, et al. Molecular evolution of the tprC, D,
I, K, G, and J genes in the pathogenic genus Treponema. Mol Biol Evol.
2006;23:2220–2233.
42 Hillis DM, Moritz C, Mable BK, eds. Molecular Systematics. 2nd ed.
Sunderland, MA; Sinauer Associates: 1996
43 Harper KN, Ocampo PS, Steiner BM, et al. On the origin of the treponematoses:
a phylogenetic approach. PLoS Negl Trop Dis. 2008;2:e148.
44 de Melo FL, de Mello JC, Fraga AM, et al. Syphilis at the crossroad of
phylogenetics and paleopathology. PLoS Negl Trop Dis. 2010;4:e575.
of the beard is quite noticeable. Untreated the disease persists
indefinitely. Periods of quiescence alternate with exacerbations
and the outbreak of acute symptoms is as a rule without any
apparent cause. Sycosis on the upper lip, which is a favorite
location, is often associated with chronic rhinitis. The nasal
secretion may be the cause of the sycosis or the sycosis by
extension may affect the vibrissae and cause the Schneiderian
membrane to become swollen and exquisitely sensitive. Sycosis
sometimes develops from eczema of the bearded region.
The disease is feebly contagious and in not infrequently transmitted
by the barber shop razor. The pyogenic staphylococci
are invariably present in the pus.
DIAGNOSIS: Numerous pustules pierced by hairs are almost
pathognomonic of the disease. Trichophytosis barbae begins
as a scaling spot and later produces a lumpy condition of
the skin; from every node many hairs project and these may
be twisted, split or broken. The spores are easily found with
the microscope. In pustular eczema the pustules are not so
accurately located about the hairs, the crusting is greater and
the crusts cover raw, oozing surfaces. The disease spreads
readily to non-hairy parts. Itching is severe.
TREATMENT: Epilation is the most essential part of the treatment.
Each day all the hairs in a given area of the affected
region should be extracted. Pasta zinci Lassar, N. F., is to be
applied plentifully and kept as constantly as possible in close
contact with the skin. In very obstinate cases with thickening
of the skin the amount of salicylic acid may be increased to
10-15 per cent. Exposures to the X-rays carried to the point
of producing a slight erythema and falling of the hair, have a
brilliant curative effect, but every precaution must be observed
not to cause dermatitis actinica.
Origin and Evolution of Syphilis