Rupia

RUPIA (rupia), unique, oyster shell-like layering crusts and scabs. Due to alternating peripheral growth, the concentrically constructed massive cone-shaped layered crust, corresponding to a spreading pustule or ulcer surrounded by inflammatory infiltration, appears thicker in the center than at the periphery and can sometimes reach large dimensions. The color of rupia crusts depends on their mode of development. They are yellowish when consisting mainly of dried serum, greenish when arising from pus, or brown-red due to admixture of bloody fluid. Syphilitic rupia (R. syphilitica) occurs mainly in very exhausted and weakened subjects, most of whom have not undergone specific treatment, usually in small numbers, located mainly on the limbs and face. After removal of the crust, an ulcer with deep purulent tissue decay is exposed. Syphilitic rupia usually heals with a deep scar surrounded by a hyperchromic border. The course of syphilitic rupia is chronic. Diagnosis presents no difficulties, as rupia is often accompanied by other changes characteristic of the late period of syphilis. rupioid crusts also occur in other processes accompanied by scab formation (smallpox, pemphigus, impetigo, psoriasis), but unlike syphilitic rupia, in the rupioid form of psoriasis (psoriasis ostracea), no ulcers are found under the thick compact crusts. For correct recognition and appropriate treatment, it is necessary to remove rupioid crusts with softening agents (Ung. emolliens, lanolin mixed with vaseline under compress paper).

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