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Help and advice if anyone can

Help and advice if anyone can

Posted By
Amanda R
2/10/2019 6:23pm
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Replies: 2

I need some sound advice as I am feeling very confused and stuck in making this important decision. Please someone if you have any sound advice for me. I can hardly get thru my day. 

back in October I had a spot biopsied at my request that was irritated due to rubbing. It was 6-7 mm and was punch biopsed with a 5mm punch and stitched up: 

the report came back no definitive diagnosis just “traumatic changes” and stated there was focal necrosis of the epidermis. 

I became concerned that maybe the irritation or “focal necrosis” caused a misread of the pathology and possible missed diagnosis of mel insitu or worse. I sent my slides off for a second review and it came back with a little more detail stating “multi focal epidermal necrosis and hyperplasia  no significant atypia of melanocyte seen.” 

my concern is that because of the irritation that it skewed the pathology so they couldnt read the melanocytes correctly and so possibly missed a high lesion? Is this possible/logical? Or if there is atypia would it be readily apparent despite irritation? 

My other concern is that what was left behind could have been atypical. 

i have a derm who is willing to go in excise the spot (now scar with a little red pigment coming back) completely and send it off for step sectioning and stains. My question is would going back in now be able to find any atypical process if it were there? 

I am going back and forth on having the area excised for fear of possibly missing something again and then never knowing the true lesion and leaving me wondering if something will show up metastatically ..where as if I left it and there was something initially there that had been missed because of irritation it would most likely grow back in that spot and I would know for sure then that something was missed but by then it may well be mel. What would you do? I am sick to my stomach thinking about this and making the best decision. 

Thank you to anyone who is willing to chime in with experience or wisdom help of any kind-Amanda

 

Amanda

I could be wrong, but I do not believe scratching a mole would change the pathology in any significant way.  If paying for an excision and the physical proof  would give you peace of mind, do it.  But I think people prior to a biopsy pick at and scratch ithcy moles pretty frequently.

Thankyou for your response!

Amanda