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How Can Chronic Pigmented Lesions On The Back Be Treated?
Question: Hello Doctor!
About seventeen years ago, my primary care doctor removed about six pigmented lesions from my back using electrodessication and currettage. He said the lesions were all normal on visual inspection, and I had actually visited a dermatologist about a year prior, who expressed no concern with them. I had the lesions before removal for about sixteen years with none of them changing, all were light to medium brown, symmetrical, uniform in color, and none bigger than a pencil eraser. All that is left now, seventeen years later, are flat white hypopogmented areas where the lesions were removed. I go for yearly skin exams and my doctor has said that everything on my back looks fine. I'm attaching an image of my back; the red spots you see are areas that were just treated by my dermatologist a few days ago using freezing and electrocautery (they were seborrheic keratosis and cherry angiomas)
My concern is that my doctor never had biopsies performed on the lesions removed. Is it safe to say that, after seventeen years now, if they had been anything dangerous, changes would have been apparent on the skin by now in the locations, such as pigment changes, etc.? One doctor I had asked indicated that if a lesion is not fully treated the cells that remain if abnormal might grow undetected. I would presume that dangerous changes would first be visible on the skin, such as pigment reappearing, a hard nodule forming, etc.??
I'm currently suffering from some health anxiety....thanks for any reassurances which you can provide!
About seventeen years ago, my primary care doctor removed about six pigmented lesions from my back using electrodessication and currettage. He said the lesions were all normal on visual inspection, and I had actually visited a dermatologist about a year prior, who expressed no concern with them. I had the lesions before removal for about sixteen years with none of them changing, all were light to medium brown, symmetrical, uniform in color, and none bigger than a pencil eraser. All that is left now, seventeen years later, are flat white hypopogmented areas where the lesions were removed. I go for yearly skin exams and my doctor has said that everything on my back looks fine. I'm attaching an image of my back; the red spots you see are areas that were just treated by my dermatologist a few days ago using freezing and electrocautery (they were seborrheic keratosis and cherry angiomas)
My concern is that my doctor never had biopsies performed on the lesions removed. Is it safe to say that, after seventeen years now, if they had been anything dangerous, changes would have been apparent on the skin by now in the locations, such as pigment changes, etc.? One doctor I had asked indicated that if a lesion is not fully treated the cells that remain if abnormal might grow undetected. I would presume that dangerous changes would first be visible on the skin, such as pigment reappearing, a hard nodule forming, etc.??
I'm currently suffering from some health anxiety....thanks for any reassurances which you can provide!
Brief Answer:
Clarification regarding your concern about the nature of pigmented lesions
Detailed Answer:
Hello. How are you doing? hope I can help you with your concern.
I have had a look at the image and the treated spots seem to be healing well.
The fact that your doctor never even felt the need for a skin biopsy is indicative that those pigmented lesions that were removed were benign and there was absolutely no doubt about them being malignant or pre malignant. Clinical examination and/or any morphological changes on serial observations of skin often dictate the need for a biopsy. So, a clinically stable/ benign lesions would not usually be biopsied unless it requires excision as treatment.
Your presumption about an incompletely removed malignant lesion subsequently presenting with local skin changes like color change within a scar or a new nodule appearing is absolutely correct. That is how a relapse of a skin malignancy usually presents. There is no recommendation for detailed systemic or radiological investigations in the absence of any systemic symptoms of malignancy. Seventeen years without any visible changes is a long time and is very much reassuring that those lesions were benign.
Regards
Clarification regarding your concern about the nature of pigmented lesions
Detailed Answer:
Hello. How are you doing? hope I can help you with your concern.
I have had a look at the image and the treated spots seem to be healing well.
The fact that your doctor never even felt the need for a skin biopsy is indicative that those pigmented lesions that were removed were benign and there was absolutely no doubt about them being malignant or pre malignant. Clinical examination and/or any morphological changes on serial observations of skin often dictate the need for a biopsy. So, a clinically stable/ benign lesions would not usually be biopsied unless it requires excision as treatment.
Your presumption about an incompletely removed malignant lesion subsequently presenting with local skin changes like color change within a scar or a new nodule appearing is absolutely correct. That is how a relapse of a skin malignancy usually presents. There is no recommendation for detailed systemic or radiological investigations in the absence of any systemic symptoms of malignancy. Seventeen years without any visible changes is a long time and is very much reassuring that those lesions were benign.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Dr. Kakkar! Once again, you have completely put my mind at ease, and I thank you for that immensely! I was doing fine and not worrying about these old lesions removed years ago, until I consulted an online dermatologist here in the US (I definitely prefer all of you doctors there in India!), who made the comment saying that if abnormal cells aren't removed completely, they can grow undetected (classic sign of hypochondria -- seeking further reassurances, although that one backfired and sent me into a tailspin!)
Since I was able to send you an image of my back, you don't see anything concerning, correct? Again, the red areas were just treated by my dermatologist. some of the hypopigmented areas are from the lesions removed years ago, and others pretty much just developed (I have several on my arms as well).
Thank you again immensely for being there and for being an absolute godsend to me!!
Since I was able to send you an image of my back, you don't see anything concerning, correct? Again, the red areas were just treated by my dermatologist. some of the hypopigmented areas are from the lesions removed years ago, and others pretty much just developed (I have several on my arms as well).
Thank you again immensely for being there and for being an absolute godsend to me!!
Brief Answer:
Use a topical.antibiotic ointment
Detailed Answer:
Hi.
No. I did not see anything concerning except that I see a little infection at the base. You may apply a topical antibiotic ointment e.g 2% mupirocin over the spots that were removed. That would take care of the infection and allow faster healing.
Regards
Use a topical.antibiotic ointment
Detailed Answer:
Hi.
No. I did not see anything concerning except that I see a little infection at the base. You may apply a topical antibiotic ointment e.g 2% mupirocin over the spots that were removed. That would take care of the infection and allow faster healing.
Regards
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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