@cicihi4 You do have quite a drive to get to your "puzzle" doctor as you call your dermatologist! Cute way to phrase it - I assume that's because they need to figure out what's going on is like putting together pieces of a puzzle?

So if I'm understanding correctly, you were given three options for treatment of this latest puzzle - the "solution" of which was squamous cell carcinoma (SCC) and you chose a large, deep excision in the shin with results pending to be certain all the margins are clear? Correct me if I'm wrong, but I'd imagine that would require less stitches than MOH's; still uncomfortable but not as intensive, is that a fair assessment?

Merkel Cell Carcinoma is intense; fortunately treatment is available for that as well. Sounds like you have a good provider who is staying well on top of surveillance and wisely including you in decision making. I'll be away the first two weeks of August but can you tell me how your visit goes then, or if you hear more prior to that visit?