4 Benign Lesions Removed From President’s Face

Four benign lesions have been removed from President Bush’s face, the White House said Monday.

The announcement came only after reporters noticed spots on the president’s face during a ceremony marking the end of the Muslim holy month of Ramadan.

White House Press Secretary Ari Fleischer said the lesions were treated and removed with liquid nitrogen, a process known as freezing. The procedure was carried out Friday in the office of the White House physician.

Such lesions generally develop as a result of exposure to the sun, often over many years. Fleischer said Bush now routinely uses sunscreen and undergoes periodic evaluations to monitor the condition of his skin.

Two of the lesions were “very early” actinic keratoses on the president’s cheeks, Fleischer said. They were similar to three removed during a physical examination last August. The other two, on Bush’s forehead and temple, were seborrheic keratoses.

The latter are always benign and do not develop into cancer, said Dr. Mark Lebwohl, chairman of the department of dermatology at the Mount Sinai School of Medicine in New York. They are waxy or scaly growths that are removed for cosmetic reasons or because they have become irritated.

Actinic keratoses, however, can be precancerous.

In the case of a patient with multiple actinic keratoses that are left untreated, a small number likely would develop into skin cancer, Lebwohl said.

Fleischer said no biopsies were indicated and none was completed.

“It is not uncommon to notice redness, darkening of the lesion or peeling of the skin [similar to a sunburn] after freezing,” Fleischer said in a written statement.

Lebwohl suggested that Bush, 55, is a likely candidate for such lesions.

“He grew up in Texas, a light-skinned guy in a place with a lot of sun,” the dermatologist said.

While such lesions are routinely found on patients in their 50s and 60s, he said, dermatologists are seeing actinic keratoses in patients as young as in their 20s.

President Clinton and President Reagan both underwent procedures for skin cancer during their White House years. Clinton had a lesion that was found to be basal cell carcinoma removed from his back; he also had a precancerous lesion removed from his nose. A small patch of cancerous skin was removed from the tip of Reagan’s nose.