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Journalism of Courage
PUNE, July 23: A small beauty spot can add to the attractiveness of a face. But a big, hairy patch on any part of the body could mar loveliness. Such was the unusual case presented to skin specialist Dr. Dilip Shah last year, the first, he says in all his 18 years of experience.
“A couple who clearly came from a rural background walked into the clinic along with their five year-old boy. Thirty per cent of the child’s lower back was covered by a big black patch which was in turn covered with hair while smaller roundish patches were also present on his upper back,” he says. The boy’s parents, ignorant of the serious skin condition of the child had assumed that it was some kind of curse. They had visited village quacks and temples where they offered sacrifices. The child had become an object of curiosity and people from neighbouring villages would come to see the extraordinary case. The parents as a last resort had come to Shah’s clinic.
“It was a most unusual case of a giant pigmented nevus. This is a rare congenital condition which arises due to grouping of melanocytes, cells that produce the pigment melanin, which gives the skin its colour. It has been observed that these patches usually occur on the trunk, thigh, neck and buttocks and with age become elevated and corrugated with a thicker hair growth. The giant nevus is actually a benign tumour that has a 10 per cent chance of turning malignant as the child attains puberty. Also associated with the giant nevus are abnormalilties of the bone like a club foot or the spine. The muscles under the patch have a tendency to become atropic (shrink in size) or hyper-tropic (over-developed),” he explains.
The boy in this case had a club foot although he had no other abnormalities. In cases of giant pigmented nevus the solutions that are available are full thickness skin grafting, which Shah asserts was not practical in this case. “The boy was only five years old, an age when the skin is still growing.
Skin grafting would be practicable only after the child attains puberty, when the skin structure is fully developed,” he says. Shah believes that in this case counselling the parents was of paramount importance. “I explained to the parents that this was not a form of curse or manifestation of evil in the child but a skin condition that required care. A condition like this would affect the child’s psychologically due to the social embarrassment attached to it. I had asked the parents to bring the boy to me every six months but they have not done so,” he rues.
