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Aldara
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Aldara

I am a 54 yo female with growths on my face, scalp, and wrist.  The oldest have been there over 15 years.

My first dermatologist said they were actinic keratoses, and froze 2 of them and curetted and cauterized one. I asked if there was a topical treatment, and he said no. He biopsied one but I don't know the results. They grew back. Then I got 2 more on my cheek and went back, and he said they were acne and refused to do anything.

Once I talked a GP into freezing them. They grew back. I tried again, and they told me to see a dermatologist.

I started freezing them myself using a wart-freezing kit. I got rid of maybe 30%. (Doctors 0%).  I knew that there were several topical treatments out there, so I researched them and decided Aldara was my best bet.

This year I got a BUNCH of new ones on my chin and cheeks. A new dermatologist said they were a staph infection AFTER I asked for Aldara. (15 years, remember)  I got depressed, wondering if I was going to be one of those people who die of treatable skin cancer.  I saw another who said they were warts, froze them, and said there was no topical treatment.

I stayed in my house last week with 9 purple, swollen, weeping sores on my face from the freezing.  If I saw somebody who looked like me on the sidewalk, I think I would cross the street.  And you can't use makeup on something that is weeping.  Today I looked in the mirror and can see that five of them are growing back already.  Oh, and there are two he missed entirely.

I know Aldara might work for AK or warts. I know what the side effects are.  I even know what the rumored horrible deathly side effects are.  What do they have against prescribing it? Do they just want to charge me for the treatment over and over and over again?
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242489_tn?1210500813
Actinic keratoses (AK's) do not look like"purple, swollen, weeping sores."  Also, they do not come in bunches on the chin and cheeks.  Actinic keratoses, although premalignant, have a very low risk of causing serious harm.  Based on your description of the spots and your highly emotional reaction to them, I strongly suspect that you are going after them with your fingers, not to mention home freezing kits.  My advice to you therefore is to absolutely, completely leave them alone for no less than one month.  Second, please call the doctor who performed the biopsies and find out what they showed.  Third, do not use Aldara.  Your face has been attacked enough.  Finally, see a dermatologist after you have done all these things.  If they tell you you don't have actinic keratoses, then take them at their word and look into the psychological help you need for what sounds to me like OCD (obsessive-compulsive disorder.)  Needless to say, this is just my best guess without having seen you in person.  But if you don't leave the spots entirely alone, even doctors in person won't be able to tell you what you have.

Good luck.

Dr. Rockoff
4 Comments
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Avatar_n_tn
1.  The "purple, swollen, weeping sores" were from the freezing--which was clearly stated in the question. Tthe dermatologist had warned me that this freezing would be more agressive than I had experienced previously.  It was indeed.  The point I wanted to make was that repeated courses of freezing could be worse than an Aldara reaction.

2.  My "highly emotional reaction" was not to the lesions themselves, but to the fact that two doctors refused to help me, and lied to me to get around their obligation to do so.

3.  I see a psychiatrist occasionally for other reasons, and told him about the dermatologists who refused to treat me.  HE told me there was nothing wrong with me, that this time it was the doctors.  He was the one who told me that a lot of dermatologists are in it for the money, and they want you to keep coming back for treatment for something that is curable.  He knew that they had lied to me.  He also knows I don't have OCD.  And he laughed at the stupidity of the doctor who said it was a staph infection, not because the diagnosis was clearly wrong, but because if he was going to dream up a diagnosis to lie to me about, he could have picked something that fit the symptoms.

4.  The lesions on my cheeks and chin are affected by the soap I use for mild acne, which has salicylic acid in it.  I have found that the only makeup that covers them is makeup for acne, which also has salicylic acid in it.  So it is true that I have done something to them to alter their appearance, but that is no excuse for two different dermatologists to refuse to look at the ones on my scalp, which have not been subjected to salicylic acid.  I told them both that the ones on my scalp were unnafffected by anything I had done, and they would not look at them.

5.  I have never gone to a dermatologist within two months of freezing anything on my own,  I know doctors object to self-treatment, and will not see one when there is any evidence of it.  I don't lie to them about it, though.

6.  You assume that I am picking at them.  The only time I pick at them is if there is a loose edge sticking out, which I cut off with manicure scissors so that I can get makeup on.

7.  You say that AK's do not come in bunches.  Apparently you didn't read the part about how the last doctor said they were WARTS.  And I didn't say they were in a bunch, just that I got a number of them.  

8.  I suggest you look up the DSM diagnostic criteria for OCD before you make this diagnosis on somebody else.  Seeing three doctors in 15 years can hardly be called obsessive.  Seeing two doctors in a six-month period when the first one refuses to even look at the lesions can hardly be called obsessive.  Self-treatment when the medical profession refuses to treat is perfectly sane behavior, especially when it is occasionally successful and hasn't caused scars.

9.  In the event that these are AK's, I am familiar with the potential for malignancy.  I even spent some time a few years back trying to determine what it was, and recognized there is no practical, scientific way of determining that.  I did find out that the more you have and the longer you have them, the greater the likelihood of malgnancy.  I have about 15 right now (nine on my face), have cured about a dozen, and the two oldest have been there at least 15 years.  Now, on a per-lesion, per-year basis....

10.  I wrote the dermatologist who diagnosed the AK and asked for the biopsy record.  He did not respond.  His office will not provide it based upon a telephone request.  I suspect he charged me for the biopsy and never had it looked at, because I never got a bill from a pathology lab for it.

11.  I bet you don't read this message any closer than you read my question.  But your attitude has answered the question I asked in the first place, even if your words didn't.  For once I got my money's worth.

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242489_tn?1210500813
OK.  I have never seen anyone with your constellation of symptoms.  I don't know what you have.  Sorry I can't be of more help.

Dr. Rockoff
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Avatar_n_tn
Ha!  I didn't ask for a diagnosis.  If I had wanted a diagnosis, I would have described the lesions.  The question was what dermatologists have against prescribing Aldara.
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