They are true tumors but they are not cancers. That's what I try to remember to tell every patient I see with a lipoma. Because they are lumps just under the skin they are often confused with skin cysts but the key difference is that cysts are fluid filled and lipomas are solid. The name "lipoma" tells you exactly what it is: "lipo"= fat and "oma"= tumor so a lipoma is a fatty tumor but (again) almost never a cancerous tumor. Lipomas will grow but they won't spread to distant parts of the body. They can be multiple or solitary but they eventually become bothersome like the one I saw not long ago on the back of a 32-year-old man. "This thing is bugging me and I want it off. What is it, anyway?" I explained that it was likely a lipoma and therefore not dangerous but it probably will continue to enlarge. I have seen some pretty big lipomas poking out of a t-shirt! I have removed lipomas the size of a pencil eraser and some the size of California grapefruit. They are usually fairly straightforward in their removal but they can have "fingers" of branching off fatty tumors that [...]

When a patient calls in and says, "I have 5 or so moles, I want you to look them over" I am happy to do it but chances are good that one out of the 5 is actually a mole and the others are (probably) benign skin lesions that most people just call "moles". A mole (the medical term is nevus) is a collection of pigmented cells called melanocytes. They can be in odd places on the body, they can be acceptable to the patient in a cosmetic kind of way or they can be not at all acceptable. They can be "suspicious" in that they can force you to wonder about a skin cancer. So when people come in and say, "can you take his off?", I do it if at all possible. Sometimes I recommend it be sent to a pathologist for identification but sometimes I can tell just by looking that it's not a dangerous "mole". You should know that most moles are not cancers. In general, cancer is ugly... not symmetrical, not having regular borders but irregular(jagged), not one color but sometimes more than one, and cancer tends to change and not stay the same. Benign things [...]

"I just got sick and tired of being an "assembly line" doctor"! I knew immediately what she meant by that statement, she was on the medical treadmill and going nowhere. Her previous places of employment as a doctor were like production lines, impersonal and cold and neither the patients nor the doctors were happy. But the concept of an assembly line can actually be a good thing in health care, it's not the assembly line that's the problem as much as the people responsible for running it. An assembly line is just a system, a system that allows for maximum efficiency. Take the world's most famous assembly line, the one designed by Henry Ford. In the autumn of 1908, Henry Ford's first Model T rolled out. It cost $825. While much less expensive than the other cars of that time, for Ford it was still too expensive. Ford was convinced that ordinary hard-working people needed cars and his cars were still not affordable for the masses. In 1913, he visited a meat packing plant in Chicago and saw how the large slabs of meat were on an overhead trolley system and butchers would slice off their piece of meat as [...]

Recently a man came into our clinic and had a bloody t shirt wrapped around his thigh. He said, "I cut my leg pretty bad this morning when I was using my hand saw, do you think I need stitches? Within that question are several other questions and I think I have the answers for all of them: The answer for him was "yes, you will benefit from stitches", once I saw the wound. Stitches are recommended for many reasons which include: to stop minor bleeding, to close the wound after a thorough cleaning of it, to prevent an unsightly scar, to encourage faster healing and help prevent infection. But does everybody need stitches? Not at all: Just about any wound will heal under normal circumstances (no infection, good blood supply, adequate nutrition) but it takes much longer and requires constant care. There are times when we don't recommend sewing up a cut especially if the wound is uncommonly dirty and/or already infected. In that case, sewing up the cut just traps the already present bacteria in the wound and in a matter of 2-3 the patient would be back and the sutures would have to be removed so the infection can drain. [...]

He was a big guy but he was hurting when he walked in the door. "I have a very sore lump on my back, it's draining some stuff that smells terrible" was what he told me and I agreed. He had a skin cyst that needed surgical intervention and he had come to the right place. Skin cysts are sometimes no problem and sometimes they are problems that need a minor surgical procedure. They are just sacs located just under the skin surface that have an outer wall and an inner "filling" with liquid or semi-solid material. Most skin cysts are called Epidermoid cysts (commonly called Sebaceous cysts) and are filled with a thick, foul-smelling protein called keratin. They are prone to infection with Staph skin bacteria that normally inhabits the skin. They are not cancer, they are not life-threatening but they can be bothersome especially if they become infected and an abscess forms around the cyst. So here's what I did... Like any pus that's trapped in a closed space, it needed to be surgically drained. I numbed the skin around the cyst with local anesthesia and made an incision right over the cyst/abscess and drained the infection [...]