( Originally Published 1936 )
SPOTS ON OLDER FOLKS SKIN MAY PROVE TO BE CANCEROUS
EVERYONE must have noticed the occurrence of plaques of roughness upon the skin of middle-aged and elderly people, especially those of a light or sandy complexion. These spots are known as "keratoses." Their importance is due to the fact that some of them are actually the earliest stage of cancer, and that their removal pre-vents the development of cancer in that spot.
There are two forms of keratoses in elderly people. The seborrheic keratoses are almost always harmless. The senile keratoses, on the other hand, if left alone, in a large percentage of cases, become cancerous.
The seborrheic keratoses are also called "seborrheic warts," or "senile warts," and may occur as early as 40 years of age. They are likely to appear on the forehead and in the temple region near the hairline, the scalp and the cheeks. They also are found on the chest and the back. They sometimes appear on the arm, rarely on the fore-arm, and never upon the back of the hand. They are flat topped, oval, slightly elevated, light to dark brown, and covered with a greasy scale.
The senile keratosis is not always possible to differentiate from the flat or seborrheic keratosis, except by cutting a small piece of the skin out and putting it under the microscope. The senile keratoses are usually found on the exposed surfaces, the neck, face and the backs of the hands. They seldom occur on the covered portions of the body. They are round or oval, flat, covered with a gray or black scale, which is hard, dry and difficult to remove. They seldom occur under the age of 60; they occur more often in men than in women; more often in blonds than in brunettes; more often in those who live out-of-door lives and are exposed to the sun.
With the approach of summer, it is interesting to read the words of an eminent dermatologist, as follows: "If the present vogue of excessive sun and artificial light bathing does not soon pass out of fashion, we may reasonably expect an increase in pre-cancerous skin diseases among those who are susceptible to the influence of the ultra-violet light of the sun."
That there are certain people who are so susceptible is unquestioned. In general, they may be described as those of sandy complex-ion, with rough, dry skin and a tendency to freckles.
In treatment, the seborrheic keratoses may be removed with carbon dioxide, coagulation current or simple excision. The senile keratoses should be entirely destroyed, either by excision, or with radium or the x-ray, or electric coagulation.