Part 68

#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:--

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

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

Operative measures, such as punctate and linear scarification, electrolysis and excision, are occasionally practised, but the results are rarely satisfactory and permanent; not infrequently, indeed, renewed activity in the progress of the growth is noted to follow. The x-ray can be tried with some hope of improvement. The administration of thyroid has been thought to have a possible influence in some instances.

#Fibroma.# (Synonyms: Molluscum Fibrosum; Fibroma Molluscum.)

#What do you understand by fibroma?#

Fibroma is a connective-tissue new growth characterized by one or more sessile or pedunculated, pea- to egg-sized or larger, soft or firm, rounded, painless tumors, seated beneath and in the skin.

#Describe the clinical appearances of fibroma.#

The growth may be single, in which case it is apt to be pedunculated or pendulous, and attain considerable dimensions; as a result of weight or pressure surface-ulceration may occur. Or, as commonly met with, the lesions are numerous, scattered over large surface, and vary in size from a pea to a cherry; the overlying skin being normal, pinkish or reddish, loose, stretched, hypertrophied or atrophied.

The tumors are painless. The general health is not involved.

#What is the course of fibroma?#

Chronic and persistent.

#What is the etiology of fibroma?#

The cause is not known. Heredity is often noted. The affection is not common.

#State the pathology of fibroma.#

The growths are variously thought to have their origin in the connective tissue of the corium, or in that of the walls of the hair-sac, or in the connective-tissue framework of the fatty tissue. Recent tumors are composed of gelatinous, newly-formed connective tissue, and the older growths of a dense, firmly-packed, fibrous tissue.

#From what growths is fibroma to be differentiated?#

From molluscum contagiosum, neuroma and lipoma; the first is differentiated by its central aperture or depression, neuroma by its painfulness, and lipoma by its lobulated character and soft feel.

#Give the prognosis of fibroma.#

The disease is persistent, and irresponsive to all treatment save operative measures.

#What is the treatment of fibroma?#

Treatment consists, when desired and practicable, in the removal of the growths by the knife, or in large and pedunculated tumors by the ligature or by the galvano-cautery.

#Neuroma.#

#Describe neuroma.#

Neuroma of the skin is an exceedingly rare disease, characterized by the formation of variously-sized, usually numerous, firm, immovable and elastic fibrous tubercles containing new nerve-elements, and accompanied by violent, paroxysmal pain. Their growth is slow and usually progressive. Later they are painful upon pressure. They are limited to one region.