Had to do a tricky skin excision this morning in clinic.

[Aristus]

It was on the patient's penis.

It was just a skin tag, completely benign; but for cosmetic reasons, obviously, the patient wanted it removed. Turned out to be not much trouble. But if the guy felt any apprehension, I could identify with that. Not a place you want sharp things close to.

[In_The_Wind]

1. Well, he was in good hands.

[Aristus]

2. Okay, there was no way you could have phrased that any better?

[In_The_Wind]

3. It was a no brainer.

[Aristus]

4. So was the area of the excision.

Except according to some women...

[rug]

5. Be glad it wasn't a snake bite.

[Aristus]

6. Yeah, I've heard that one before...

[CaliforniaPeggy]

7. I have every confidence in you, my dear Aristus!

I knew, even before I got to the end of your post, that you did just fine...as did your patient.

Well done!

[Aristus]

8. Thanks, CalPeg.

And the only trouble, (and you'll laugh at this) is that neither I nor my assistant had much experience applying a sterile dressing to this particular site before. It required a little trial and error...

[CaliforniaPeggy]

9. I'm afraid you're right...I did giggle a little!

But really. How often do we put a sterile dressing there???

[KamaAina]

10. So how is Mr. Bobbitt doing?

[Denninmi]

11. Ouch.

Maybe this could open up a second career for you as a mohel.

[Aristus]

12. Hey, why not?

Hear, O Israel!
The Lord our God,
The Lord is One

THWACK!

[MicaelS]

13. So why are these things called "skin tags" these days...

And not "moles" as they used to be? First time I heard the term "skin tag", I went WTF is that? The latest slang term for tattoos?

[Aristus]

15. A skin tag is usually the same color as the surrounding skin.

A mole, or nevus, is pigmented.

[MicaelS]

17. Ah, ok, thank you.

Learned something new today.

How do you feel about the use of LN2 to remove skin tags in non-genital areas? I've had some cut off, and didn't like that.

[MissMillie]

14. Just out of curiosity....

did the patient's insurance pay for the excision?

I only ask because I lost a lot of weight and I have about 12 lbs. of skin I'd like removed, but since I don't have any complications from the excess skin, the procedures are considered "cosmetic" and therefore not covered.

Of course I understand that the cost involved for my stuff is much higher, but cosmetic is cosmetic--right?

[Aristus]

16. My patients are homeless.

Their care is covered under a grant unless they have insurance, (and about 1/3 of my patients do. And after Jan 1, 2014, most of them will.)

[MissMillie]

18. ok

I was just curious if some cosmetic procedures are covered.

I imagine some are because there being no physical implications, sometimes the psychological implications can be pretty traumatic.

I wonder if I could convince anyone that 12 lbs of excess skin is psychologically damaging...... (probably not)

[struggle4progress]

19. Isn't it possible to remove skin tags with just a pair of tweezers?

Never mind: I didn't realize how large they could become

[tonekat]

20. This reminds me of an old Bill Cosby stand up routine

Oops.

Dr: Clamp. Hemostat. Oops.

Patient: Whaddya say?

Dr: Nothing, go back to sleep.

Patient: I heard you say oops. I know what I done when I say oops, what did you do sayin' oops there?

[MiddleFingerMom]

21. I didn't know you spoke Tagalog!!!

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Ang aking mga buto ay napakalubha ngayon. Salamat sa iyo, Aristus
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