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What the heck did the dermatologist do to me!? Nitrogen?

jones1
Posts: 3
Joined: Jun 2014

The dermatologist I went to was roughly 80 years old.  I know age shouldn't matter. But he's a hard core, old school type of guy.  I got to ask no questions, he asked no history, nothing.

 

I showed him the "spot" I was worried about on my chest. He said "huh...yea we could probably take that off".  I asked him what he thought it was (the only question I got to ask). He said "well I don't think it's cancer, looks like pre-cancer".  He said it was probably acnetic keratosis? (which I'm not sure about either...it wasn't a rough patch or scaly or anything. Just a pink, little bit raised spot).  

 

Before I could even try to ask any more, he came at me with a long cotton swab with stuff on the end....next thing I know Im seeing a vapor like substance and feeling a hot/cold burn sensation.  It all happpend so fast.  :(

 

Anyway....since he didn't explain anything...does it sound like he used liquid nitrogen? And if he did...wouldn't that have destroyed any kinda biopsy that could have been done? (he did do a "shave" on it).  Just everything I read, once you freeze the lesion, there's almost nothing TO biopsy.

 

That was a week ago today.  Still not results in as of yesterday.

Rague
Posts: 3660
Joined: Aug 2009

I have had quite a few pre-cancerous lesion burned/frozen off for years.  Most have not come back at all but a few have and were burned/frozen again.  A very few have come back after the second time.  Those that came back after that were then surgically removed and biopsied.  3 have been Squamous Cell Carcinoma amd 1was Basal Cell Carcinoma.

The only one that was red/pink is the BCC.  Also it was only burned/frozen once before it was surgically removed and biopsied as it had come back quickly.  I am an Imflammatory Breast Cancer survivor too.  One of the places IBC 'likes' to metastis to is the skin so when a reddened area developed on my arm on the same side as the IBC had been, my Drs had been more concerned and more aggressive even though they believed that it wasn't a met.  The path. report definately ruled out an IBC met. but only BCC.

It does sound like liquid nitrogen was used.  I've never had it put on from a cotton swab but rather from a canister with a narrow tube to direct it to the site.

Winyan - The Power Within

Susan

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jones1
Posts: 3
Joined: Jun 2014

I'm just concerned that there's a (very) slim chance it may have been melanoma...and the lab may not even be able to tell because it was "burned" off. The doctor never mentioned melanoma and didn't even think it was any kind of cancer...just the acnetic keratosis. But some of those amelanotic melanomas I've seen online,  do look similar to what I had.

 

More or less, my question is, can a lab even tell anything by the biopsy sent in since the nitrogen was used? I just have this fear that I may never know what it was...or wasn't!

Also, I am wondering if he used the nitrogen more to numb things than to actually freeze it off.  Because other than that, there was NO deading before he did the shave. I've had shave biopsies before and I always have had an injection of some type.  But no injections this time!

Rague
Posts: 3660
Joined: Aug 2009

I'm no expert on it but to me it seems like using nitrogen as a numbing agent or to freeze the area would make a difference with rather or not the lab could run the pathology.  As I understand it (could be wrong), the lesion is not immediately gone from the nitrogen.  The area will 'blister', open up, and then heal over days and in that time the 'nastiness' will be gone and new healthy tissues grows back if it was successful.  If not, it will come back.

I've never had nitrogen used as a numbing agent but there are other sprays/creams/liquids that can be used for numbing.  I've only had an injection for 2 of my biopsies - 1 near eye and other on side of nose.  The other ones I figured the injections would hurt as much it would to just do the biopsy if they were ones I wasn't expecting that day.   The ones I expect, I just put EMLA cream on 1/2 hr before appt so the area is already numbed just in case.

I know basically nothing about melanoma.  Perhaps I'm wrong but I've been told to watch for dark, irregular borders and not even top and bottom.

Perhaps someone else will show up that knows more but there aren't usually a lot of posts in this sections - sometimes going weeks without new posts.

 

jones1
Posts: 3
Joined: Jun 2014

I called a little while ago. They actually finally had the lab results back.  (if they can be trusted after the whole liquid nitrogen ordeal)

 

The final pathology showed it was a linchenoid keratosis.  Completely benign and harmless.  Enough to scare the crap out of me for almost a week though!!

 

Next time I'll ask more questions and demand answers.  The waiting game is bad enough...but to know you had questions you couldn't even ask, just to ease your mind a little bit?...THAT was horrible!!

 

Thank you for the input and responses!

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