Blog Layout
April Mohs Case Presentation - Cystic Basal Cell Carcinoma
Dr. David Roy • Apr 03, 2019
A 61 year-old female patient presented to our Pine Belt Dermatology complaining of a sore lesion on her nose (Figure 1).
She stated that the spot had been tender and bleeding for several months and that it had been diagnosed as a cyst and treated with antibiotics. Despite treatment, the lesion demonstrated no improvement which caused the patient to become concerned and schedule a consultation. Kristen Richardson, PA-C was able to biopsy the lesion to get the patient an accurate diagnosis.
A biopsy of the lesion revealed a cystic basal cell carcinoma. Basal cell carcinoma begins in the basal cells — a type of cell within the skin that produces new skin cells as old ones die off. Basal cell carcinoma often appears as a slightly transparent bump on the skin, though it can take other forms. Basal cell carcinoma occurs most often on areas of the skin that are exposed to the sun, such as your head, neck, and face.
Basal cell carcinoma appears as a change in the skin, such as a growth or a sore that won't heal. These changes in the skin, or lesions, usually have one of the following characteristics:
- A pearly white, skin-colored or pink bump that is translucent, meaning you can see a bit through the surface. Tiny blood vessels are often visible. In people with darker skin tones, the lesion would be darker but still somewhat translucent. The most common type of basal cell carcinoma, this lesion often appears on the face, ears or neck. The lesion may rupture, bleed and scab over.
- A brown, black or blue lesion — or a lesion with dark spots — with a slightly raised, translucent border.
- A flat, scaly, reddish patch with a raised edge is more common on the back or chest. Over time, these patches can grow quite large.
- A white, waxy, scar-like lesion without a clearly defined border, called morpheaform basal cell carcinoma, is the least common. This lesion is easy to overlook, but it may be a sign of a particularly invasive and disfiguring cancer.
After discussing treatment options including Mohs surgery, radiation therapy, and oral targeted therapy, the patient decided that Mohs surgery would be the best option due to its high cure rate.
The surgery and microscopic evaluation of the tissue revealed a very large and aggressive tumor that had invaded deeply into the nose. The tumor was much larger than it looked and involved a significant portion of the nose (Figure 2).
After discussing several closure options, including a flap and graft closure, the patient and I decided upon a rotation flap from the right side of her nose. This would allow for a single stage procedure, excellent tissue match in terms of skin texture and color, and relative quick healing time (Figure 3).
After one week, the patient was seen for suture removal with excellent early results (Figure 4).
Three weeks after her surgery, her nose is centered and level, the tissue color and texture are appropriate, and scarring is minimal (Figure 5). This case demonstrates the utility of flap closure, even for very large defects of the nose. It allows for the procedure to be completed in one day and requires only one week of downtime and wound care for the patient.
Basal cell carcinomas are the most common skin cancers diagnosed each year. Be sure to have yourself and your loved ones examined once a year to monitor lesions. If you have a family history of skin cancer Pine Belt Dermatology recommends getting them
Yeast infections on the skin can be uncomfortable and persistent if not properly managed. Medically known as cutaneous candidiasis, a yeast infection on the skin arises when a fungus called Candida albicans overstays its welcome.
As the spring season unfolds, many individuals eagerly anticipate spending more time outdoors, reveling in the beauty of blooming flowers and vibrant landscapes. However, for some, spring brings about a different experience—one characterized by itchy, irritated skin and uncomfortable allergic reactions. Skin conditions associated with allergies or heightened exposure to outdoor elements can significantly impact individuals' quality of life during this time.
Skin cancer is one of the most common types of cancer worldwide, affecting millions of people every year. The good news is that, with early detection, the majority of skin cancers are highly treatable. Regular skin cancer screenings play a crucial role in identifying potential issues before they escalate.
As winter blankets the world in a serene layer of snow and chilly temperatures, many of us tend to believe that the need for sunscreen diminishes along with the intensity of the sun's rays. The misconception that sunscreen isn’t essential during the winter can lead to unintended consequences for our skin.
We all love that golden glow from a day spent basking in the sun, but what about those days when the sun decides to take a break? That's where indoor tanning comes into play, right? Well, hold on to your tanning goggles because there’s more to this seemingly harmless activity than meets the eye.
Your skin is a window into the health and happiness of your whole body. As the body's largest organ, it plays a pivotal role in physical protection and shaping your identity and self-esteem. Seeking the guidance of a dermatologist is a wise decision when faced with skin issues, be it medical or cosmetic. However, the challenge lies in how to find the perfect dermatologist who can address your unique concerns and requirements.
The key to soft and radiant skin often lies in our daily routines. Home-based skincare goes beyond mere daily practice; it signifies a dedication to the well-being of your skin and a much-desired glow.
If you're like most people, you desire flawless skin that radiates confidence and natural beauty. We understand that achieving and maintaining healthy skin can be challenging, especially with the countless cosmetic skin treatments available and the staggering number of product reviews.
In the world of skincare, there are many myths and misconceptions that can make it difficult to tell what is true and what is not. From extravagant claims about miracle ingredients to misguided beliefs about skincare practices, these myths can hinder our journey towards healthy, glowing skin.
The warm embrace of the sun holds a hidden danger called skin cancer. This pervasive disease affects millions in the United States, with over 5.4 million cases diagnosed annually. As the numbers continue to rise, it's crucial to shed light on this menacing threat. Fortunately, with early detection and the right treatment, you can safeguard the well-being of your or a loved one’s skin.
Phone:
Address:
Hours of Operation:
Mon-Fri: 8:00am to 4:30pm
Phone:
Address:
Hours of Operation:
Mon-Fri: 8:00am to 4:30pm