4 Growths Removed From Bush’s Face : Checkup: Untreated, such cells could become cancerous. Doctors give President clean bill of health after physical.

Doctors removed four “very minute” growths known as keratoses from President Bush’s face Thursday, the White House said. If left untreated, such collections of cells can develop into skin cancer.

Bush pronounced himself in “perfect” health and so did his doctors, although the White House physician said Bush should take a vacation. White House Press Secretary Marlin Fitzwater said after the President underwent an annual physical examination that there was no evidence of skin cancer.

Dr. Burton Lee III, the White House physician, said the growths were removed with a squirt of liquid nitrogen, which freezes them and causes them to drop off.

“It is not of health significance,” Lee said in a brief interview.

However, he said, the keratoses were removed because “a certain percentage of them, if you leave them alone, will go on to become basal cells,” which are cancerous. In 1986, when he was vice president, Bush had a basal cell skin cancer removed from his face.

He said they were discovered by a dermatologist, who spent five to 10 minutes examining Bush’s face with the aid of magnifying glasses.

The initial White House statement on Bush’s four-hour physical, which was conducted at the Bethesda Naval Hospital, made no mention of the skin condition. However, when a photographer noticed spots on the President’s face and the White House press office was asked about the condition, a second statement disclosing the treatment and similar treatments in the past, was made public.

Fitzwater said that the “small dark spots” caused by the treatment will disappear “within a few days.”

Lee said a 1990 diagnosis of glaucoma in the President’s left eye had been a mistake and, although elevated pressure had been detected there Thursday, “the disease of glaucoma has many features and he has none of the features of glaucoma.”

The examination was the first such thorough check of the President’s health since he was treated nearly a year ago for Graves’ disease, a thyroid disorder that produced heart arrhythmia, for which he was hospitalized.

The doctor said that the President’s heart was “perfect.”

“No extra palpitations, no extra heartbeats, his rhythm strips are normal, the echocardiogram is normal, his EKG is normal, stress test, normal,” Lee said.

He said Bush wants to take a vacation “and I have directed him to go.”

The President, who is 2 1/2 months shy of his 68th birthday, customarily takes a fishing trip to Florida in the spring and generally begins his warm-weather visits to his home in Kennebunkport, Me., in May. He now has a weekend visit to Maine scheduled for the Easter holiday.

Asked why Bush should take a vacation, Lee replied: “Why not?”

“This is on general principle,” he said, stressing that he had no specific health concerns that Bush is fatigued and needs a vacation.

“There is nobody who has been President of the United States that it doesn’t take a toll on. It’s my job to see he stays in the best condition. I have always been trying to have him take more and more time off. He responded very positively, but none of us knows how he’s going to take time off,” the doctor said.

Bush routinely uses various exercise machines in the White House and has resumed jogging since the episode of arrhythmia last year. In addition, he plays tennis on the White House tennis courts and races through a golf course at such a pace that his game has been dubbed “aerobic golf.”

In a written statement, Lee said Bush “will continue his normal busy work schedule and physical activity.”

However, the examination determined “mild degenerative osteoarthritis,” wear and tear on the joints that occurs in most people as they age.

Lee told reporters that he still prescribes the sleeping drug Halcion for Bush, when he thinks the President needs it, despite the controversy over its potentially harmful side effects. He said he has not given it to the President since Bush’s trip to Japan last January. It was on that trip that Bush suffered from a bout of gastroenteritis and vomited at an official dinner.