lesion on nose

[nlmorgan]

I first noticed a small lesion on my nose at the start of 2001. I thought nothing of it till mid 2007 when, out of vanity I decided to get it dealt with. It was about 2 mm, circular, and slightly raised. Like a very small redish blister. In truth, almost undetectable.

I went to my doctor who said the best thing to do was to just shave the top of it off 'because we don't want to put a hole in your nose' or words to that effect. 2 weeks later I was seen by another doctor who was going to remove it, and to my great surprise he said that it was a small skin cancer - a BCC. This was suprising for 2 reasons. 1. The previous doctor had never mentioned it  and  2. I had had it for over 6 1/2 years and it had not grown/changed shape at all -  (localised growth being a fundamental trait of a BCC I later discovered).

Anyway, he cut it out and it was not until I had the stiches removed that, to my horror, I realised he had done a punch biopsy (which I never agreed to). I thought he would just be taking the top off it, as per the original suggestion from the Doctor I had first seen. In fact he had removed an area probably 3 times the size of it, and cut down underneath it as well, leaving me with a sunken scar which is very noticeable in bright light.

The biopsy report later confirmed what I suspected. It was harmless and not cancerous in any way.


My question therefore is this:

Given that the lesion had exhibited absolutely no growth or alteration in over 6 years, remaining at no more than 2 mm across, was the Doctor right to think it was a BCC and then to cut it out?


As I now have a scar that I have to live with I am considering taking this further as I feel his misdiagnosis was negligent.

[Alan Rockoff, MD]

Biopsy to rule out a basal cell is usually done by a superficial shave biopsy or by scooping a small amount of tissue with an instrument called a curette.  A punch is not generally necessary.  When you say the biopsy "was harmless and not cancerous in any way," what did it show?  A mole?  If it did show a basal cell, then it is necessary to take more skin around it to make sure it doesn't come back.  Basal cells do grow slowly, but over 6+ years it should have grown more.  

I advise you to get copies of the biopsy reports and consult another dermatologist in person.  Maybe the best one to consult is the first one, who wanted to do a shave biopsy.

Best.

Dr. Rockoff