The pimple that led to multiple surgeries

What’s the big deal about a pimple? You can either pop it (even though dermatologists advise against it) or let it dry out naturally. But what if that seemingly harmless pimple is a warning sign of something much more serious?

For Judith Maundu and Dennis Ratemo, the journey that started with a pimple on their son’s arm has taken them down a path filled with surgeries, emotional turmoil, and, most recently, an unexpected diagnosis.

It all began one morning in 2020 when Ratemo noticed a small bump just below their 6-year-old son, Tadashi Sipho's elbow. “It looked like a pimple,” he recalls. “At first, I thought nothing of it.” But as days passed, the bump didn’t go away; in fact, it started to grow.

Concerned, they took their son to a paediatrician, who reassured them that it was just a boil. “He said we should wait until it matured and would likely go away on its own,” the father of two says. "But intuition told me something wasn’t right. The lump kept growing, and it didn’t feel like a typical boil anymore."

Eventually, they returned to the doctor, who referred them to a plastic surgeon. The diagnosis? A lipoma—a fatty lump that forms under the skin. “The surgeon explained that sometimes lipomas don’t cause any problems, and we could either remove it or leave it,” Ratemo says. After much deliberation, they decided to wait it out for a few months. The boy wasn’t in any pain, after all.

But by December 2021, the lump had grown, prompting the first surgery. The surgeon’s initial hunch was confirmed—the lump was indeed a lipoma. However, not long after the surgery, things took a turn. Their son’s hand began to swell, and the family was back at the surgeon’s office.

“Tests showed that fluid had accumulated in the wrist, a condition called seroma,” Judith explains. Their son was now facing his second surgery to drain the fluid. “He was traumatised. He couldn’t understand what was happening to him. It was really difficult,” She explains.

Tadashi was still in school during this period, so the parents took him for weekly check-ups. His hand was healing, but there were complications: keloid scarring, which can often form after surgery.

Things seemed to calm down until one day, their son came home from school with a swollen hand. “It was red and painful, and there were lumps with pimples around it,” Ratemo remembers. They decided to seek treatment at a different hospital, where another surgery was recommended. The surgeon removed a mass that had formed under the skin.

But just when they thought the issue was behind them, the problem resurfaced. “We were waiting for the third procedure when, one day, during a dressing change, water just gushed out of his hand. We were all shocked,” Judith says. Instead of improving, the hand began to stiffen.

This led to a fourth surgery. “It was a quick procedure, only about 30 minutes,” Tadashi's father recalls. “It seemed like a success, but when the bandage was removed, the problem was still there.”

By early 2024, the couple had reached their wit’s end. Despite multiple surgeries, they still didn’t have a clear diagnosis. “That’s when we went to another specialist. This doctor immediately noticed the scar tissue and said, ‘This doesn’t look good,’” Judith shares.

At this point, they had to take a break from their son’s schooling to focus on his ongoing treatment. The new specialist recommended a more aggressive approach—removing the mass from his hand entirely and sending it to the pathologist for proper analysis.

The fifth surgery was particularly tough. “He was so scared because of all the previous surgeries. We had to encourage him through it,” Judith says. After this procedure, skin expanders were used to help the skin cover the affected area. They also placed a catheter to drain the remaining fluid. “I was pregnant at the time, so I was very emotional through the whole process,” she adds.

Despite all the challenges, there was a moment of relief when they were told they had found the answers they had been searching for. But the healing didn’t end there. The doctors found that their son’s hand wasn’t expanding as expected, which meant a sixth surgery was necessary. This time, they used skin grafts from his thigh to cover the hand.

“It was the hardest thing to see my child go through, but after a week, we were finally able to remove the bandages. His hand had healed, but we still had to focus on scar management using silicone patches,” Judith explains. Thankfully, their insurance helped cover most of the costs, which were to the tune of Sh3 million.  “There are still some indentations on the skin, and he tends to form keloids,” Ratemo says. But the family is grateful for the progress they’ve made.

Interestingly, the original diagnosis of a lipoma was changed after the second and fourth surgeries, when the condition was labelled a haemangioma- a benign tumour of blood vessels. 

“The final diagnosis was Dermatofibrosarcoma Protuberans, a type of soft tissue sarcoma that often starts as a small, firm bump under the skin. It can resemble a boil, pimple, or cyst at first, which may be why it's mistaken for a benign skin condition initially. “The doctors told us that it was difficult to detect because of its size and the way it presented,” says the father of three. The doctors explained that if left untreated, it could spread into the bones and even risk amputation.

“That was the turning point,” remarks Judith. “We realised how important it was to catch things early. If we hadn’t sought second opinions, we might not have caught it in time.”

With their son’s treatment now completed, the family is focused on helping raise awareness. “The good thing is, the mass is completely gone, and his hand is healing although we are considering a reconstruction surgery in the near future to improve the appearance of the depression left on the hand,” Judith says. “In reflection, we are glad we sought other doctors' opinions.”

Lnjeru@ke.nationmedia.com