KELOLD.
This term is usually applied to the hypertrophic changes which occur in scar tissue, and the " true keloid found in the skin without any evidence of previous wound is believed to be due to the same unknown causes operating upon minute abrasions.
Since most of the keloid growths tend to disappear they should not be interfered with till watched for a considerable period; all that is necessary is to protect the growth by a layer of adhesive plaster spread upon soft chamois or where pain or itching is present to paint the scar tissue over with a layer of Salicylic Collodion.
Should the keloid be upon any part of the body where uniform elastic pressure can be applied then a rubber bandage put on fairly tightly will often cause its disappearance. Finsen's Light and the X-ray treatment have in recent years afforded some very satisfactory results.
Fibrolysin should be tried in every case before resorting to operative treatment, twelve to fifteen injections being made at some distance from the scar tissue. As return is so often observed to follow excision, this should he avoided as long as no obvious disfigurement results; a number of deep linear scarifications may he made so as to divide the vessels feeding the keloid, and when this method has been combined with electrolysis, fibrolysin, massage and the X. rays the best has been done for the case. Should the claw-like processes continue to grow outwards into the surrounding skin the surgeon must treat the case as iL it was a fibro-sarcomatous growth, and excise the hypertrophied cicatrix with its numerous prolongations, cutting clear of all fibrous structure and filling in the gaps in the skin with numerous Thiersch grafts. Caustics should never be employed for the destruction of the growth, as return in an aggravated form is very liable to follow their use.
KERATITIS—see under Cornea. KERATOSIS.
This term is applied to several distinct skin affections characterised by an accumulation of the horny cells of the epidermis, such as occurs -t7S KERATOSIS-- KNEE-JOINT DISEASE in the milder forms of ichthyosis. The treatment of this latter condition,
known as Keratosis I'ilaris, has been already described under Ichthyosis. It consists in repeated bathing and cleansing with soap and friction, and the continuous inunction of the affected parts by an emollient ointment or oil.
Keratosis resulting from chronic arsenical poisoning usually affects the palms and soles, and yields naturally upon stopping the administration of the drug and keeping the thickened skin well moistened by any greasy ointment. If the accumulated cells fail to disappear under such simple treatment a paste of Salic> lie Acid will speedily remove them.
Keratosis Fcllicularis (Darier's Disease, Ichthyosis Sebacea Cornea) is the result of infection by psorosperms, and is refractory in its treatment. The crust-topped papules should be removed as soon as they appear by the application of the thermo-cautery, and after cleansing and mild friction in a warm alkaline bath to remove the nodular masses a paste of Salicylic Acid (1 part in 8 parts of glycerin) should be applied.
The last-mentioned treatment is also the most suitable for Keratosis Nigricans, but should the wart-like accumulations continue to grow in spite of salicylic treatment they may be excised.
Keratosis affecting the palms and soles, when not of arsenical origin, is rebellious to treatment. After thoroughly softening the cells with alkaline soap and prolonged immersion in hot water Salicylic Paste in 8) should he applied perseveringly, or the same agent may be employed in double strength in the form of plaster or as a solution in ether (r in ro).