Joan liked the feeling of insects crawling over her skin. It meant they were not stuck under it anymore.
For a short while during puberty she had thought everyone who got zits had to squeeze little bugs from them occasionally. The reactions to her mentioning it taught her differently. The reactions to her demonstrating so people would stop calling her a liar taught her to keep it secret.
She told herself that it wasn't so bad. It was normal for her, like his red-green-blindness was normal for her father. And anyway it was just one or two at a time, and it wasn't that much worse than popping another fat zit. And acne would fade away after puberty.
Ony for Joan it didn't.
Living in a new town on her own, no-one who knew asked how she was doing. It made it easier to pretend to be normal, which made up for the few insect zits that grew on her back, where she couldn't reach them. They would grow hard and painful, until the small bug inside was ready to crawl out.
Gradually, things grew worse. Instead of tiny things smaller than caraway seeds, more varieties started growing under her skin. Here something the size of a grain of rice, with red patterned wings... She got rid of them, and went on with things.
It was pulling a grasshopper, most of an inch long with its ovipositor, out of the flesh of her upper arm that broke her.
The landlord had to open the door eventually. She had removed enough of her skin with sandpaper that she had bled to death.