A huge blackhead extracted on the back!

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This patient and his father have been patients of mine for a long time. In fact, his father was a patient of my father's who retired over a decade ago.
His father passed away last year, so it's a little strange when I see him in the office without his father - they always came in together and liked to joke with each other and with me... I miss him!
This patient recently had back surgery and one of the nurses suggested that he have this bump evaluated on his back. I had given him a skin exam last year, and probably saw this bump during my exam, but because it is a benign blackhead (albeit quite large), I reassured him that it was nothing to be worried about and encouraged him to leave it alone.
Well, how much a year changes things! Now, since I post these types of videos on youtube, when I saw this I immediately knew this would be a GREAT extraction. He is so sweet to allow me to film it for you all to enjoy!
You may hear me in this video speaking about how this blackhead may have converted into a cyst. Well, I can't say this is absolutely true. Perhaps that "sac wall" is just really packed down skin cells that form a sort of "skin", much like you make paper out of pulp. So, I decided that the NEXT time I see one of these and I remove tissue like this, I will send this tissue for pathology so we can look at it under the microscope. By doing this, we will know whether this is in face the wall of an epidermoid cyst, or instead just tightly packed keratin, which is what we find within blackheads and cysts.

So, you will have to stay tuned for the next one!
Thank you so much for watching!!

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This video may contain dermatologic surgical and/or procedural content. The content seen in this video is provided only for medical education purposes and is not intended to be a substitute for professional medical advice, diagnosis, or treatment.