Last week I posted about a woman so obese she couldn’t be taken out of the ambulance to try to resuscitate her from cardiac arrest. Today I share another obesity-related story.
My patient was a man in his early twenties. He was complaining of having trouble sleeping at night and having sores “by my penis.”
As for his first complaint, it was pretty obvious he had obstructive sleep apnea, a common condition where the airway closes down at night causing people to wake frequently. It is usually not life-threatening but it makes people miserable by keeping them from resting. It is much more common in obese people and this kid was massively obese. I made arrangements for him to be referred to the sleep clinic for evaluation.
To evaluate the sores by his penis, I pulled the sheet down and saw what I thought was a huge, inflamed scrotum hanging down almost to his knees. However, when I pushed his belly fat up to get a better look, there was no penis by the scrotum. That’s when I realized that what I originally thought was his scrotum was actually his mons pubis, the area where pubic hairs grow. I could then see that his sores were caused by inflammation of the hair follicles of his pubic hairs, or folliculitis.
With two hands, I lifted the mons up off his thighs and looked underneath it. Then, I could see a little penis and scrotum way down between his legs.
Amazing and very sad.
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