Skin Cancer Concern on Nose

[Mark802]

I have a concern about skin cancer. Wisely or not, I have in the past treated some abnormalities on my nose with a natural escharotic called “black & yellow salve.” The history: Three years ago I applied the black salve to a bump on the tip of my nose that had been bleeding and healing repeatedly for several months. To my surprise, the next morning a small area of white dead tissue was visible in the area. Eventually the area healed, but left the skin a little uneven.

Everything seemed okay until almost three years later (last April), when I had another small bump on the same spot. I repeated the salve treatment. Again, same reaction. Coincidentally, during this time I visited a walk-in clinic for an ear infection. The physician noticed the area around the tip of my nose and said he was concerned I might have a basal cell carcinoma there. I applied the black salve again and this time an even smaller amount of white tissue appeared. Within a couple days, it fell off and again the skin healed.

Everything seemed fine until about the second week of November, when a very small spot on the right side of my nose bled a little when I rubbed it. Again, using the salve a small area of white tissue arose. By now I was very worried. I saw a dermatologist, who identified the spot as dead tissue, suggesting we wait a couple weeks. If necessary, he would possibly biopsy it at that time. He also took note of several keratosis spots on my forehead and face. Two weeks passed and nothing there. However, he did say the skin on the tip of my nose was still uneven, making it difficult to say for sure there wasn’t a possible bcc there.

Meanwhile, just a week and a half ago, I noticed another abnormality (small white bump) on the left side of my nose. In a panic I applied the salve to the spot (despite deciding not to use it anymore). Within an hour, the tissue reacted and rose to the surface. I called the dermatologist, who said since the salve was caustic, it could be reacting with any skin condition, such as a pimple or infected or clogged pore. It may not even be any type of skin cancer. He told me I should not worry, but for the sake of diagnosis not to use the salve anymore. He has also suggested I see a Moh’s surgeon specialist for consultation.

The dermatologist had also noted as an area to watch the red, flaky area on the upper part of the bridge of my nose. Well, this week this area began to feel tender, which I hadn’t noticed before. I examined it and washed off the flaky skin. It feels like there is a slight bump there, but a friend who felt the area carefully couldn’t notice. The area is red, like a cherry angioma.

My crazy fear is that I have some underlying cancer that is spreading in multiple spots around my nose area. I would appreciate some grounded perspective on all this. I’m hyper-focused on this. About 12 years ago I had a bcc on the upper part of my forehead. It was removed with no complications. I had little worry about that at the time.

[Alan Rockoff, MD]

If you see and (apparently) trust a dermatologist, and if you had a basal cell removed by a doctor years ago, why on earth are you using an esharotic on your nose?  How do you expect anyone to know what you have if you keep this up?  I have no idea whether you've been masking skin cancers by ripping their tops off or (more likely) burning off normal skin.

There is no way to know what you have (or whether you have anything) unless you leave the skin alone and let a doctor see what's going on so a biopsy can be done if indicated.  Escharotics, which can mask skin cancers until they burst forth, not to mention leave unsightly scars, are a truly lousy idea.  Especially on your nose!

Good luck.

Dr. Rockoff

[Mark802]

Thank you, Dr. Rockoff. To add an explanation, I had used the salve initially for two reasons: I didn't have health insurance at the time, and it was affordable. I also respected the opinion of the practitioner who recommended it to me. But I regret now the uncertainty this situation has created. The dermatologist I've seen recently has told me I should't be too concerned. He also told me most recently that basal cells take a long time to develop, and it's unlikely these recent spots/bumps, which seemed to appear overnight, are necessarily cause for concern. (But he is concerned about the anxiety I've had, however.) I should add that all this takes place against a backdrop of recovery from a serious accident a year ago, in which I severed my left quadriceps tendon, had surgery, a brace for several months, and a year of learning to walk again. It's left me feeling more vulnerable than usual.

[Alan Rockoff, MD]

Got it.  But your dermatologist is right about basal cells growing slowly.  I too am concerned about your anxiety, specifically about the fact that this anxiety is causing you to take unwise steps.  Ditto the sense of vulnerability....

Dr. Rockoff

[willea01]

I recently (a few months ago) devolped a small white bump on left side of tip of my nose.  I thought it was a pimple but it was not when I tried removing it, it bled and evntullly flaked and healed.  I am 37 and I am 1 year post testicular cancer / chemo.   My wife and mom are concerned.  Could it be just a new mole or wart or should I be concerned? I appreciate any feedback.