Did I have a mole a wart or skin cancer?

Moles and basal cell lesions can be hard to differentiate
Moles and basal cell lesions can be hard to differentiate

A little over a year ago I noticed what looked like a small pimple or possibly an infected hair follicle on my upper lip. I squeezed a little exudate out of it and cleaned it with alcohol and applied an antibiotic ointment, thinking that it would be gone in three or four days. It didn’t go away as quickly as things like that usually do. It grew fairly rapidly. It started to look like a pale-colored mole about 5 mm — less than a quarter of an inch — across. I tried to remove it a couple of times; once by using an over the counter wart-freezing spray and later a salicylic acid liquid-bandage type of product. Both times it got small enough that I thought it was about gone, but then it came right back to its original size in a few days.

While I was at the VA Outpatient Clinic in Charlotte for an annual physical, I asked Dr. Patel to take a look at the sore on my lip. She did and said she wasn’t sure what it was but that she would schedule an appointment with a dermatologist.  A few days later the dermatologist said that it would need to be removed just to be safe and made an appointment with the minor surgery department for me to have it taken care of the following Monday.

The surgeon looked at the sore on my lip in rapt attention, as if he were studying something for a final exam — like he was trying to memorize every detail. He was so focused on it that it made me feel uncomfortable. He finally looked up and said, “Yep, we need to take that out.”

I was glad that it was going to be taken care of. Still thinking that it might be a mole or some sort of persistent wart, I asked him if he had a diagnosis. Without skipping a beat of any kind he said, “You have a basal cell carcinoma. I’ll send a specimen to the lab to make sure — after we cut it out.”

I’ve had a mustache for over 40 years, so my image in the mirror this morning doesn’t look quite right without it. The bandage feels like it covers my whole face. The stitches are the type that will dissolve and it hurts a little, but I am more than glad to have this thing over and done with.

In retrospect, I was more concerned about my slightly elevated cholesterol, than I was about that thing on my lip. Now that I have proven that I can make cancer, I’ll be a little more careful about pooh-poohing any little lumps or bumps that might pop up in the future.

Thank God for annual checkups and the Veterans Administration.

Skin Cancer : Epidemic From The Sun

by David B. Schulman M.D., F.A.A.D.

There is a true epidemic of skin cancer in America. One million cases of skin cancer will occur this year in America. Lifelong sun exposure is increasing for Americans as we spend more time outdoors and the sun’s rays are becoming more intense with our loss of ozone. The use of tanning booths is a new way to further damage our skin and raise our risk for skin cancers. There are three common forms of skin cancer and we are seeing dramatic annual increases in the number of these skin cancers. Melanoma, which is the most aggressive form of skin cancer, is now the most common cause of cancer deaths in American women under forty years old.

Basal Cell Carcinoma The most common and least aggressive form of skin cancer is basal cell carcinoma. This is the most common cancer in America and happily it causes nearly no fatalities. This cancer is most common on light skinned people and thirty percent of Caucasian people in America are expected to have a basal cell in their lifetime. The great majority of basal cell carcinomas will occur on the head and neck. Though this form of cancer almost never enters the bloodstream or the lymph system, it may be locally invasive. Basal cells do grow by local extension and over time can erode and invade not just skin, but other important areas down to muscle or bone. There are more aggressive forms of basal cell carcinoma that will infiltrate and extend below the surface more than above the surface. These tumors are especially dangerous for the surrounding tissue. Basal cell tumors often appear as pale or translucent patches or raised bumps on the skin with fine blood vessels in them. They may grow for months or years without detection. The often ulcerate and bleed as they grow, but otherwise have no symptoms like itching or pain. The tendency towards growing basal cells is inherited and many patients report at least one family member with a history of basal cell. Patients will often have more than one basal cell in their lifetime and I have seen patients who have had dozens of them. Darker skin tends to get fewer basal cells but one of the first lesions I had in my new practice was an African-American women with a basal cell on the leg. She is fine and nearly everyone who has this is fine. With early detection and removal this should simply be a speed bump on the road of life.