Under My Skin



People hate bumps.

Bumps are ugly. Bumps are nasty. Bumps bother.

Seeing bumps makes people frown. Touching bumps makes them shudder.

Bumps on toads. Bumps on potatoes. Bumps on trees.

But especially bumps on skin – on faces, on lips, on tongues, on genitals. Bumps almost anywhere.

Bumps bother the people who have them. They especially agitate other people who have to look at them, so they point out the bumps and make it perfectly plain how bumps make them feel:

• "My wife says, ‘When are you going to get that disgusting red spot off your neck?’" (About a hemangioma.)

• "My kids say, ‘Dad, when are you getting that gross thing off your back?’" (About an epidermoid cyst.)

• "That black spot on your back – have you had that looked at?" (A doctor – not a dermatologist, of course – asks a patient about a dermal nevus you’ve been reassuring that patient about for years.)

"Just leave those skin tags on your neck alone," you say.

"But they’re nasty! Can’t you take them off?"

"I suggest you leave the cyst alone. Removing it would require surgery."

"But I hate it!"

Even nonverbal observers can call attention to bumps. More than one nursing mother has had me remove a mole from her breast, even though it’s been there without changing for a long time, because "the baby keeps grabbing at it."

But once the people who see bumps can talk, it’s open bump season. My wife had a blue nevus removed from her cheek many years ago. She recalls that she did it because our youngest son, about 8 years old at the time, kept pointing to her cheek and saying, "Blue nevus! Blue nevus!" (Yes, he could be irritating then, but no, he wasn’t diagnostically precocious – I’d told him what it was.)

That son now has three children of his own, so he can look to his own parenting challenges, not to mention his own blemishes.

The loaded words people apply to their bumps – ugly, disgusting, gross, nasty – are not the ones you’d expect, and they have nothing to do with histology or malignant potential. But if you listen for these words, you’ll hear them as often as I do.

Some of my bumpy conversations are droll in unexpected ways. Last week, for instance, Seth came in for his annual physical.

"I have these two things under my left arm," he said, pointing to a pair of skin tags.

"Do they bother you?" I asked.

"They bother my kids," he said. "Adam and Melissa keep pointing at them. They call them Fred."

"Fred? What do they call the other one?"

"Also Fred."

"Did you know," I asked him, "that all little thingies hanging off the body are male? People always say, ‘Can’t you get rid of those little guys?’ "

"I didn’t know that," said Seth.

"You see what you can learn at the dermatologist’s office?" I said. "If you want, I can make your kids happy and get rid of Fred. Both of him."

"Sure," said Seth. I loaded up my electric needle. I don’t play video games. Who needs when you have a Hyfrecator? Soon Fred was vaporized. BLAMMM! So was Fred. KAPOWW!

"Seth," I said, "if Dr. Seuss had written a book about dermatology, he might have called it ‘Bye, Bye, Fred’ and it may have gone like this":

See Fred.

Fred bled.

Fred bled red.

Fred bled red in bed.

Zap, Fred! Pow, Fred!

Now Fred is dead.

Sayonara, Fred.

Go ahead, moles, warts, skin tags, bumps of all kinds. Make my day.

Dr. Rockoff practices dermatology in Brookline, Mass. To respond to this column, e-mail him at our editorial offices at sknews@elsevier.com.

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