Hyperkeratotic "growth" at Mohs surgical site
I had open wound surgery for squamous on my forearm in May '22. I had followup every couple of weeks and everything "looked great." Last week I went for another place on my hand and they looked at the surgical site. An almost marble sized light colored place had come up at the edge of the site. The RNP said the is hyperkeratotic–like a fast overgrowing of skin. She said it is possible the pathology did not see all clear edges as reported. We are to watch it and come back in two weeks. I may have to have additional biopsy and surgery. "Sometimes it happens." The wound the first time took two months to get to the point of not having to do daily care and bandaging. The thought of having to go through another surgery on the same place makes me a little sick on my stomach. Trying not to be dramatic but what if the pathology messes up again? Any others out there who have experienced this situation? Would love to hear from you. Blessings.
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@fdixon63 I understand your fear. Another way to think about this is that you have a second chance to fix this problem, and the earlier that is caught, the better. We are not just affected by fate… and you have the choice to change your outcome. It is so easy to focus on a negative problem and get your mind stuck there. Fear of danger helped humans evolve, but it doesn't always serve us well. We can choose to think differently and just understand that after the anxiety response, we pick ourselves up and think rationally about problem solving. I do think your provider will be focused on catching a problem and that is what you want. Make sure to ask questions. The worst that you could do is ignore it. I consider myself to be very lucky because after my husband ignored a bump on his hand for a year, I was concerned and found a dermatologist and got an appointment for him. They took a biopsy that shaved the top half off and also removed some abnormal moles. Any guesses what that bump was?
Malignant melanoma, the most dangerous and deadly of the skin cancers. Once that spreads, the chances of a cure are very low. It was the size of a pencil eraser and the same color. The dermatologist didn't recognize it and thought it was something else, but 10 days later the pathology report came back, we got a call to see a surgeon ASAP. Waited 2 weeks for that appointment, then scheduled for surgery about 2 weeks later which was big enough to require a skin graft the size of a slice of pepperoni. We were lucky. It had not spread. Now the checkups are often. It was every quarter at first, and now dermatology checks are every 6 months. Checkups with surgeon every 6 months. He has a lot of abnormal moles, and after a couple years, now they are finding less things that they want to remove and check.
After the initial biopsy, the melanoma was still present and the skin healed because it was deep. Moles that were biopsied didn't always get it all either. I learned what abnormal moles looked like and I had one between my toes, so I went for my first skin check. The biopsy didn't get it all, so I returned for a second procedure to get the rest. It's always good to get the eyes of the pathologist looking at something, and if something doesn't seem right, speak up and ask about it. I learned something too, about helping my husband who wasn't advocating for himself, and about not ignoring my own because I didn't like getting cut with sharp objects. In the grand scheme of things, those days are just a small fraction of my and my husband's lives, but if I wasn't paying attention, the consequences could have been serious and I would be grieving a very personal loss.
Yes, I am lucky, but my choices helped get me there.
Hi Jennifer. I'm so appreciative for your response. Your words and experiences brought me some comfort. Sorry you and your husband had so much to go through but it put you in a place to help others. Thanks for being a mentor.
I've had five surgeries for squamous but this is the first one that has ? come back questionable. I've never been a sun worshiper but guess it does go back to childhood exposure. With all these scars, I'll be using long sleeves and long pants from now on. Things can be worse. I see by your pic that you like horses. I rode for 40-45 years and miss that today. So to use a saying, when you get bucked off, pick yourself up and get back on. The best to you and family. Faye
@fdixon63 Thank you, Faye. Stay vigilant. The horse in my avatar picture is my old retired Tennessee Walker who was my first horse not too long ago. He helped me rehab with trail riding after spine surgery. I also have a young Tennessee Walker that I ride, and I ride with a helmet and a brim that I made for it by cutting up a hat. I also wear sun blocking long sleeved shirts and sun blocking gloves from Columbia that are for fishing. I also like BUFF gaiters to cover my face. I was a life guard outside in my younger days and tried to stay covered up, but that was back when sunscreen was new and they thought a #4 protection was enough. I did get some unintended sun exposure, but since then, I have stayed out of the sun as much as possible. Thanks so much for your kind words. I enjoy being a mentor and I learned a lot in tackling my own fears, and I like to help others who are experiencing similar things.
Here is my Sharing Mayo Clinic Story and some horse photos.
Your advice is great – wish I was part of the discussions here a year ago. Maybe I wouldn’t have lost the love of my life to that evil disease – melanoma. I’m still reeling with anger, guilt and sadness.
We have to be our own advocates and for the ones we love.
Hi Faye, I can appreciate your “oh, no!” reaction to your dermatologist’s proposal to do repeat skin surgery on the same spot. I had Moh’s surgery in February on two spots on my ankle and shin. The ten weeks of follow-up, twice-a-day changes of the bandages is a pain in the neck. But a lesser pain than the melanoma that eventually took my husband’s life. Within 10 years of surgery for the proverbial, “pencil-eraser” sized spot on his neck, his melanoma returned internally, and he didn’t have a chance the second time. Things I found helpful: Running soapy water over the wound site daily, to help shed the detritis, then rinsing and patting dry. Bandaging with a breathable, non-stick Telfa pad cut-to-size and held on by paper tape in order to allow a bit of air circulation. Follow-up cream to calm and moisturize the wound after the bandaging ends. Ask your doctor for recommendations on the type of cream. Also ask if it might speed healing to do a few arm exercises or a little gentle massage outside the bandaged area. These last two are to improve circulation.
I’m now in a holding pattern. After my Moh’s sites healed I did 5 weeks of Flourouracil, a do-it-yourself chemo ointment, on the remaining spots on my shins and ankles. Then I applied a prescription steroid ointment for two weeks to calm the angry areas left by the Flourouracil. My doctor has granted me a vacation from treatment over the summer. In September I will return to her for further evaluation. I anticipate a few more biopsies then.
Good luck. Sending up a prayer for healing, patience and optimism for you. – Jean
@jnb I'm sorry for your loss. That must be devastating, but know that you are so appreciated here and doing good by sharing your experience and helping others. Talking openly about cancer saves lives when we encourage others to take action on screenings, prevention, and advocating for themselves and family members. You are a real asset to the community.
I wanted to share with you that at the time my husband was undergoing his melanoma removal surgery at Northwestern, they were doing a study about using immunotherapy sooner for a stage 2 melanoma cancer. My husband's was stage 2a that had broken through the skin. He didn't participate because of a long drive into Chicago in crazy traffic and needing to work, but the results are that doing the standard immunotherapy for a stage 3 reduces the risk of cancer re-occurrence if done at stage 2 I think by about 25% if I remember correctly. I wasn't sure what type of cancer you had, but wanted to share that news.
There is also a genetic test from Castle labs that Northwestern did at no cost to us even though insurance wouldn't cover it. This gives a rating for cancer risks for certain types of cancer. My husband's risk is high. His surgical oncologist will follow his care for 10 years.
We also both had colonoscopies this week, and my hubby had a lot of polyps removed. I had one. We are going to need to be more vigilant about doing those too because you prevent cancer by removing the precancerous type.
Keep asking questions of your doctors. Thanks for your tips on healing.
@mlenney167 Thank you, Annie, and I'm sorry for your loss, and that was fairy recent too. My husband should not have been covering his bump on his hand with a bandaid for a year. Out of sight; out of mind. I think sometimes boys grow up not knowing how to take responsibility for their health because their moms did everything for them. They may not admit that, but that puts an extra responsibility on their wives. When you care for someone, it's so easy to take on that responsibility and the guilt, but that doesn't really belong to you. I had to say this to my husband that he should have made the initiative to find a dermatologist and take responsibility for his health, and he apologized for that and for trying to put the blame on me because he wasn't thinking about it. It wasn't until I saw how large the bump was, that I got online and started looking up dermatologists.
It's OK to be angry at the disease. Give yourself permission to express your feelings. If you are interested, there is a Loss & Grief group on Connect that is private, so you can share and receive support in a closed group.
Is there anything that you are doing to help heal from the loss? What helped me a lot when I was lost my elderly father was to create a video documentary telling the story of his life. I used my parents old photos, vacation pictures, and I had sat my parents down and recorded video a few years earlier of them talking about their lives. I added in video of my mom talking about things I had pictures for to fill in the blanks. This helped me process the pain, and I just let myself feel it and grieve. I even learned things about my dad that I hadn't known before. I know everyone grieves differently in their own time. This documentary actually was the main part of his memorial service.
Is there anything you would like to talk about? How can I help?