This is not a disease but a condition or symptom of old age. The earliest manifestation is apt to be a slight discoloration upon which in a short time the epidermis becomes horny and hard, and by thickening presents a rough and scaly surface. Usually, however, there are other signs of old age or atrophia senilis present, such as a thinning of the skin with lentigo-like or large pigmented areas, seborrheic or senile warts, greasy, crusted or scaly patches, pea-sized or larger, and small, hard, thickened epidermic spots. These last two types of lesions are the ones to which the term keratosis senilis is usually applied. Generally these changes are observed after the age of sixty but there are exceptions to this rule. While they may be located anywhere, they are most commonly found on the face and on the dorsum of the hands and feet.
Prognosis and Treatment. – Further formation or progress of these lesions can often be prevented by proper precautions but it should always be borne in mind that degenerative changes may result in a superficial epithelioma.
In its mildest manifestation any simple fat such as cold cream or vaseline applied at night and washed off in the morning, if persisted in, will stay the progress or entirely remove the eruption. If mild hardness is developed, it may be necessary to add salicylic acid in from 2 to 5 per cent. strength. Better yet, an ointment, composed of 5 to 10 grains each of salicylic acid and sulphur to one half ounce of lanolin, vaseline or cold cream, may be applied nightly after a soap and hot water washing. As the condition advances stronger local treatment is essential and here a 5 to 15 per cent. salicylic acid plaster may be applied at night with a mild ointment between times. While I have used caustics and surgical excision extensively, if scarring is to be avoided, mild fulguration or freezing with carbon dioxide is preferable. The X-rays have caused complete disappearance of these growths, but for the specific treatment of senile warts and other senile diseases of the skin the reader is referred to the other paragraphs on the subject. Some of the indicated drugs for this condition are Baryta acet., B. carb., Calcarea phos., Graphites, Mez., and Nat. mur.