Dotted white Lips : Vitiligo phobia

"Doctor , look at my lips , are they turning white?" This young lady was worried about white spot disease developing on her lips.

"No,its not , what you are thinking about.These are abnormal glands which are giving a pinpoint white appearance. Its not Vitiligo" we assured after examining her lips.

"So what doctor ? They are looking white and even if its not white spot disease but everyone would think so.Please do something" she was not happy with my assurance.

"But these are glands,its the structure of your skin,how can they just go away with medicines?" We always try to satisfy people with less or no medicine no surgery principle.

"All doctors say so, every one says its nothing.But i cant live with these spots doctor .Please do something." She was desperate.

And then we did CO2 Laser Ablation With local anaesthesia. It took an hour of very fine touching of each and every gland with magnification. Lips were turned a little red .

After one week she happily came with all normal lips . Execpt one or two dots still left and she wanted to undergo same procedure again .

"No doctor, its not possible"

"Look at this doctor, she is having these itchy rashes all over her body " while her mother was very  tense and explaining her problems with little exacerbation,  that cute small child was playful with the paperweight on the doctors table.
                     "Nothing to worry about ,this is Lichen Urticatus a sort of mosquito bite allergy " i was observing the child, she was still interested in my paperweight.
                     "No doctor this is not possible,we dnt have any mosquito in our house" her mother was not happy with my diagnosis.
                     "These rashes never appear on covered areas like back or belly, it occurs only on exposed ,open parts" i tried to convince her.
                     "No doctor there are rashes on back "she tried to find out but cdnt find any.
                     "So whatever it is, if not mosquitoes,its coming from outside,thats why only open parts are effected"i tried my best to educate her .
                      "No doctor there is no mosquito,no dust she is always indoors,how can this happen to my child"
                    She was in complete denial mode. Was she  taking my diagnosis as  blame on her parenting ? If there are a few insects its not her fault.
                    

Hope i wdnt die soon

Everytime this old man asks the same question "doctor,i hope i wdnt die soon".
                         And almost Everytime i reply in reflex "off course not, you are going to live atleast 100 years of age".
                          This man was under treatment for air borne contact dermatitis and was taking steroids on and off since several years.
                           Was it a normal joke ? A mere ice breaking attempt with serious looking doctors? Or some hidden fear of death ?             
                            Always i think about same questions and try to find out answer looking directly in his eyes .
                            Without steroids he cant live a normal life and with steroids he is not going to live long.

Scabies

"Ohh doctor this insect has made home in my skin" that old village man was humorously worried.  And i cdnt stop myself smiling.
                    Scabies is caused by a mite who makes home in your skin and a dermatologist is the  man who collects the rent.