Heads and shoulders....knees and toes.

From Geoff Miller

22 Nov 1995

Darwinius Vespasian wrote: "I have a small lump on my right shoulder, I wouldn't describe it as a spot in the normal sense, firstly because of the strange anatomy and secondly due to the contents."

Jim Davies replies: "This may be an inverted follicle, where the hair is growing the wrong way (inwards...). "


What Darwinius is describing is known as a sebaceous cyst. I know them well, having had two of the fuckers swell up and get inflamed, requiring surgical removal. The cheesy-smelling white fluffy stuff that comes out is sebaceous fluid, not pus. Unless the thing gets inflamed like mine did, though, in which case it's both.

I had one of these appear several years ago, at about the level of my navel but around to the left side. What made me aware of it, originally, was that it itched due to its filling up with fluid. I unconsciously reached down to scratch what I thought was a common skin itch and felt this marble-sized mass under my skin.

So I did what any a.t-er would do, and squeezed it. My hand was instantly filled with this odiferous, cheesy stuff, and oddly, the thing didn't hurt like pimples do when you squeeze 'em. Popping this thing was compulsive and oddly fulfilling in a way, sort of like playing with bubblewrap, and it became routine to burst it every few days as the fluid accumulated inside. I didn't know what it was at first, and figured it was just some weird kind of deep pimple that I hadn't experienced before.

Eventually the thing became severely infected somehow, probably due to bacteria getting in through the opening, and I had to go to the hospital to have it cut open and drained. I'd always pictured the thing as being the size and shape of a grape or a marble, but as the doctor probed around inside it with a pair of hemostats, he said that it was actually more like a clump of grapes, with several separate chambers that each had to be opened and drained.

Oh, a year or so I finally had that one dealt with permanently, it became similarly infected. I waited until I got home from work, then took off my shirt, went into the bathroom and squeezed the bastard hard. There was a continuous drilling sound as the thin, high-pressure stream of crud hit the mirror. It lasted for a full five seconds, maybe more, and then I went "around the clock," squeezing it from different angles to make sure that I got all the stuff out. Sort of like those final few bladder-emptying squirts when you're taking a piss, right? The deposit on the bathroom mirror was a true work of art. A vertical puddle about the size of a dinner plate, it consisted of semisolid lumps suspended in a thick liquid "broth," and it stunk to high heaven. I think I might've taken a picture of it before I went for the paper towels (toilet paper wouldn't have been up to the magnitude of that task), but I don't remember. If I did, maybe I'll find the photo some day and scan it in.

But that wasn't the best one. No, the best sebaceous cyst I've ever had appeared as a grape-sized lump on my lower back, off to one side, and remained there inert for several years. Eventually it started iching, so I started scratching and probing it one evening. That was apparently enough to make my body wake up and realize that something was there that shouldn't be, and those ol' white blood cells came racing to the rescue as I slept that night.

When I woke up the next day, this thing was just *massively* inflamed. That whole area of my back was red and sore, and it kept getting worse. So I went to the flight surgeon (I was in the Coast Guard at the time, attending school at Altus Air Force Base, Okla.). She told me to apply hot compresses to the cyst for a couple of days to draw out and concentrate the pus, and then come back to have it removed. That occasion didn't arrive a moment too soon, since the cyst had become so sore that I had to turn chairs at an angle in order not to have any direct pressure on the thing when I sat down. It was a constant, unremitting pain. Ghod, did that thing hurt!

I arrived at the flight surgeon's office at the designated time, took off my shirt, and lay face-down on the examining table. The doc shot me up with Novocaine, which hurt like a sonofabitch thanks to that whole region of my back surrounding the cyst being inflamed. She started cutting, but it still hurt. It eventually took no fewer than nine shots of anasthetic to make it possible for her to even touch my back, much less operate.

The first serious cut that the doctor made, however, was a memorable one. She lanced the top of the cyst and squeezed it lightly -- only to have a torrent of pus and smelly sebaceous fluid cover her face and the front of her tidy blue Air Force uniform shirt. She gave a startled yet dignified screech, something appropriate for a dignified captain in the medical corps who was nevertheless a woman.

The doctor worked for maybe half an hour, cutting and pulling an occasionally giving me yet another shot of Novocaine. She knew I was interested in what was going on, so she gave me a running commentary as she worked. Apprently this cyst consisted of a skin-like bag that was filled with crud. Not only did the crud have to be drained, but the bag itself had to be cut out. When the job was completed, I had what looked like a bullet hole in my lower back at about the level of my left kidney. I still have the scar, and sometimes it still itches.

The doctor packed the hole with a length of Betadine-impregnated gauze strip and covered that with a taped-on gauze square, and that was that. She told me to come back in a couple of days to have the gauze packing replaced and to try to keep the area dry for a week or so. Oh, and she showed me the little fleshy bag as I was leaving, even going to the trouble of poking through the mountain of bloody, pusy gauze squares on the little steel cart that had held her surgical tools in order to find it.

Geoff