f the hair follicles. Each elevation is pierced by
a hair, or the hair may be twisted and imprisoned within the epithelial
mass; or it may be broken off just at the point of emergence at the apex
of the papule, in which event it may be seen as a dark, central speck.
The skin is usually dry, rough and harsh, and in marked cases, to the
hand passing over it, feels not unlike a nutmeg-grater. The disease
varies in its development, in most cases being so slight as to escape
attention. As a rule, it is free from itching.

#What course does keratosis pilaris pursue?#

It is sluggish and chronic.

#Mention some of the etiological factors.#

It is not an uncommon disease, and is seen usually in those who are
unaccustomed to frequent bathing, being most frequently met with during
the winter months. It is chiefly observed during early adult life.

#Is there any difficulty in the diagnosis?#

No. It is thought at times to bear some resemblance to goose-flesh
(cutis anserina), the miliary papular syphiloderm in its desquamating
stage, and lichen scrofulosus. In goose-flesh the elevations are
evanescent and of an entirely different character; the papules of the
syphiloderm are usually generalized, of a reddish color, tend to group,
are more solid and deeply-seated, less scaly and are accompanied with
other symptoms of syphilis; in lichen scrofulosus the papules are
larger, incline to occur in groups, and appear usually upon the abdomen.

#State the prognosis.#

The disease yields readily to treatment.

#Give the treatment of keratosis pilaris.#

Frequent warm baths, with the use of a toilet soap or sapo viridis, will
usually be found curative. Alkaline baths are also useful. In obstinate
cases the ordinary mild ointments, glycerine, etc., are to be advised in
conjunction with the baths.

#Keratosis Follicularis.#

#Describe keratosis follicularis.#

Keratosis follicularis (_Darier's disease_, _ichthyosis follicularis_,
_ichthyosis sebacea cornea_, _psorospermosis_) is a rare disease
characterized by pin-head to pea-sized pointed, rounded, or
irregularly-shaped grayish, brownish, red or even black, horny papules
or elevations, arising from the sebaceous or hair-follicles. They are,
for the most part, discrete, with a tendency here and there to form
solid aggregations or areas. Many of them contain projecting cornified
plugs which may be squeezed out, leaving pit-like depressions