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Do I need a specialist and other questions

I hope I posting in the right place.

1)  Which specialist should I see to evaluate, treat or excise abnormal tissue based on a recent biopsy? Example:  dermatologist, gastroenterologist, proctologist / rectal surgeon, etc.
2)  Based on my past history, should I be worried.

I recently had a colonoscopy and before the procedure I remarked to the doctor that I had a hemorrhoid that was bothering me.  He examined me and said that there wasn’t a hemorrhoid but that the color of some of the surrounding tissue looked off and dry.  He took a biopsy of the area during the procedure.  (BTY, the itchiness and dryness could very well be from the wipes I use due to my problems with Irritable Bowel Syndrome.  When I switched to witch hazel wipes, it went away)

The biopsy came back noting some abnormalities (with terms I have no understanding of such as;  exophytic papillary tumor formation, epithelium squamous hyperplastic, cytoplasmic basophilia, anisokaryosis and mitosis, koilocytaires, dyskeratotic cells, and parakeratosis).  

More importantly his conclusion was histological appearance evocative of Bowen’s disease associated with change type HPV.  Absolutely necessary to compare clinical and paraclinical data, confirmed by new biopsy or resected specimen.  So which specialist do you recommend that I see?

PAST HISTORY

Around 21 years ago when I was living in Honolulu, I had a cyst on my inner buttock located on the border of the anus.  It was a large cyst and my doctor lanced it.  Had to put a drain in it do to its size.  Several months later I developed a skin tag in the same area.  The skin tag was removed and biopsied.  The results came back as abnormal skin changes, pretty much the same as the most recent biopsy.  I had 2 additional minor surgeries to remove more skin, but they still could not get clear margins without cutting into the anus.  At that time they recommended radiation treatments.  

I relocated to Florida and took the slide specimens to a dermatologist there.  He sent them to some facility in Wash DC and the results came back as NOT being Bowen’s disease.  He said that no further treatment would be necessary.  I relocated outside the country that same year and had a specialist there perform another biopsy and again the same results.  NOT Bowen’s disease.

Obviously the most recent biopsy is of concern and I want to have it checked out again, but given that Bowen’s disease was ruled out 20 years ago, should I be overly concerned?  I would think that if it was going to change to cancer, it would have done so long before now.

Thanks in advance
1 Responses
563773 tn?1374250139
MEDICAL PROFESSIONAL
Hello,
Bowen disease is a neoplastic skin disease, it can be considered as an early stage or intraepidermal form of squamous cell carcinoma. You need to consult an oncologist or a dermatologist who specializes in skin cancer for the diagnosis and line of treatment.
It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.


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