#Give a descriptive definition of keloid.#

Keloid is a fibro-cellular new growth of the corium appearing as one or
several variously-sized, irregularly-shaped, elevated, smooth, firm,
pinkish or pale-reddish cicatriform lesions.

#Describe the clinical appearance of keloid.#

The growth begins as a small, hard, elevated, pinkish or reddish
tubercle, increasing gradually, several months or years usually elapsing
before the tumor reaches conspicuous size. When developed, it is one or
more inches in diameter, is sharply defined, elevated, hard, rounded or
oval, fungoid or crab-shaped, and firmly implanted in the skin. It is
usually pinkish, pearl-white, or reddish, commonly devoid of hair, with
no tendency to scaliness, and with, usually, several vessels coursing
over it. In some instances it is tender, and it may be spontaneously
painful.

The breast, especially over the sternal region, is a favorite site for
its appearance. One, several or more may be present in the single case.

#What course does keloid pursue?#

Chronic; usually lasting throughout life. In rare instances spontaneous
involution takes place.

#State the etiology of keloid.#

The causes are obscure. The growth usually takes its start from some
injury or lesion of continuity; for instance, at the site of burns,
cuts, acne and smallpox scars, etc.--_cicatricial keloid, false keloid_;
or it may also, so it is thought, originate in normal skin--_spontaneous
keloid, true keloid_.

#What is the pathology of keloid?#

The lesion is a connective-tissue new growth having its seat in the
corium.

#Is there any difficulty in the diagnosis of keloid?#

No. It resembles hypertrophic scar; but this latter, which is
essentially keloidal, never extends beyond the line of injury.

#Give the prognosis.#

The growth is persistent and usually irresponsive to treatment. In some
cases, however, there is eventually a tendency to spontaneous
retrogression, up to a certain point at least.

#What is the treatment of keloid?#

Usually palliative, consisting of the continuous application of an
ointment such as the following:--

[Rx] Acidi salicylici, .................... gr. x-xx
Emplast. plumbi,
Emplast. saponis, ... [=a][=a] ....... [dram]iij
Petrolati, ........................... [dram]ij. M.

An ointment of ichthyol, twenty-five per cent. strength, rubbed in once
or twice daily, is sometimes beneficial.

Oper