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How To Treat Any Suspicious Lesion?
Question: WHAT IS PROTOCOL??had good geri dermatologist died in 09. He said ANY suspicious lesion as described: REMOVE IMMEDIATELY,ie looks like actinic keratosis, THEN BIOPSY, do not wait, take it off. That that was ACA/ADA protocol in high risk bracket.
New Doc says NO. I want your opinion. Especially at advanced age and likely to forget sunscreen every 2 hours!. And picking at these things... Where can I find info?
New Doc says NO. I want your opinion. Especially at advanced age and likely to forget sunscreen every 2 hours!. And picking at these things... Where can I find info?
Brief Answer:
It is always advisable to go for excisional biopsy
Detailed Answer:
Hello. Welcome to Healthcaremagic.com.
I have read your query.
I understand your concern.
I also advise my patients that if any lesion is of high suspicion then better to go for excisional biopsy rather than leaving it and posing the body unnecessarily to high risk.
The advantage of excisional biopsy is that it is both Curative and Diagnostic.
Sometimes clinically what seems to be irrelevant comes out as relevant.
So it is always better if possible to go for investigations to come to a final conclusion.
You should discuss this with your doctor.
I am sure he will agree with this.
I hope it helps.
Take care.
It is always advisable to go for excisional biopsy
Detailed Answer:
Hello. Welcome to Healthcaremagic.com.
I have read your query.
I understand your concern.
I also advise my patients that if any lesion is of high suspicion then better to go for excisional biopsy rather than leaving it and posing the body unnecessarily to high risk.
The advantage of excisional biopsy is that it is both Curative and Diagnostic.
Sometimes clinically what seems to be irrelevant comes out as relevant.
So it is always better if possible to go for investigations to come to a final conclusion.
You should discuss this with your doctor.
I am sure he will agree with this.
I hope it helps.
Take care.
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
I know that is advisable; of course. But as stated my question IS: WHAT IS STATED PROTOCOL?
No, as mentioned, dermatologist does not agree despite history and reports; strongly written documentation for future care from our former renown geriatric dermatologist (published in 24 languages) to remove any and all lesions immediately.
No reason given, just NO. "If you insist I can freeze it for you, we do not remove lesions in our elderly patients here."
No, as mentioned, dermatologist does not agree despite history and reports; strongly written documentation for future care from our former renown geriatric dermatologist (published in 24 languages) to remove any and all lesions immediately.
No reason given, just NO. "If you insist I can freeze it for you, we do not remove lesions in our elderly patients here."
Brief Answer:
protocol for actinic keratosis
Detailed Answer:
As per protocol, since actiic keratosis is a condition with high risk of turning into invasive Squamous cell carcinoma , the adequate treatment should be made necessary.
We here follow this protocol. We preferably remove the lesion rather than posing a person to high risk of carcinoma.
So you should take opinion of your doctor again.
You can share my opinion with him.
I hope it helps.
Take care.
protocol for actinic keratosis
Detailed Answer:
As per protocol, since actiic keratosis is a condition with high risk of turning into invasive Squamous cell carcinoma , the adequate treatment should be made necessary.
We here follow this protocol. We preferably remove the lesion rather than posing a person to high risk of carcinoma.
So you should take opinion of your doctor again.
You can share my opinion with him.
I hope it helps.
Take care.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
THANK YOU so much DR. Bansal!!!! Another expert opinion from you please... With this case history and SUN EXPOSURE being so important in skin cancer especially blue eyed blond etc. with lifelong xerosis too, not just to prevent cancer BUT OVERALL HEALTH - her SKIN, everything else, COMFORT, like turgor and prevention of skin tears, easy bruising, flaking, cracking, itching and scratching, yes she has, SUN EXPOSURE remains a big factor right? She goes outdoors a LOT. [She also I may have said PICKS at these lesions until they are bloody actinic keratosis and MOLES I have shown photos of this but NOT a BUDGE TO REMOVE THEM??? Can I contact the XXXXXXX Dermatology Association? Someone like that to get a statement on official letterhead? Any suggestions?]
BEING OLD isn't sun exposure STILL A FACTOR in one's HEALTH?!?!?!
Referring to her skin the dermatologist said; "At her age, sun exposure is not a factor anymore."
I have been told to "lay off on insisting that sunscreen be applied 'all the time.' " It is such a small effort I sure don't get it.
Um, having geriatric training I remember learning to slab the sunscreen on. Even more so in 'old age' when skin is more friable.
Working at NYs EENT I had the honor of caring for an unforgettable young man, a snowboarder, diligent about SUNSCREEN. He died, 25y/o from a melanoma lesion INSIDE his lower nostril.
I have to do something and say it all diplomatically to get her to another doctor and I need facts first. Thank you again for expert, succinct to the point information.
BEING OLD isn't sun exposure STILL A FACTOR in one's HEALTH?!?!?!
Referring to her skin the dermatologist said; "At her age, sun exposure is not a factor anymore."
I have been told to "lay off on insisting that sunscreen be applied 'all the time.' " It is such a small effort I sure don't get it.
Um, having geriatric training I remember learning to slab the sunscreen on. Even more so in 'old age' when skin is more friable.
Working at NYs EENT I had the honor of caring for an unforgettable young man, a snowboarder, diligent about SUNSCREEN. He died, 25y/o from a melanoma lesion INSIDE his lower nostril.
I have to do something and say it all diplomatically to get her to another doctor and I need facts first. Thank you again for expert, succinct to the point information.
Brief Answer:
request your doctor for second opinion
Detailed Answer:
Hello. Welcome back.
Definitely sun exposure contribute a lot in such conditions. She is already a high risk patient with so many factors attributingg as you also mentioned.
As far as contact with XXXXXXX Dermatology Association, I truly do not know the protocol .
As far as I know, you can always request your current Dermatologist to refer you to some other expert for second opinion. This is a patient' s right . If a doctor takes it in a healthy way he would definitely approve your request and would fix your appointment with another Dermatologist at higher centre.
Probably your Dermatologist is not willing for the excision because of her age. Since I have not seen the report and the lesion, so I really cannot say whether surgery is feasible or not.
The protocol suggests that surgery should be performed if high risk and risk during the surgery is negligible at this age.
Good luck.
request your doctor for second opinion
Detailed Answer:
Hello. Welcome back.
Definitely sun exposure contribute a lot in such conditions. She is already a high risk patient with so many factors attributingg as you also mentioned.
As far as contact with XXXXXXX Dermatology Association, I truly do not know the protocol .
As far as I know, you can always request your current Dermatologist to refer you to some other expert for second opinion. This is a patient' s right . If a doctor takes it in a healthy way he would definitely approve your request and would fix your appointment with another Dermatologist at higher centre.
Probably your Dermatologist is not willing for the excision because of her age. Since I have not seen the report and the lesion, so I really cannot say whether surgery is feasible or not.
The protocol suggests that surgery should be performed if high risk and risk during the surgery is negligible at this age.
Good luck.
Above answer was peer-reviewed by :
Dr. Shanthi.E
Is there any truth that SUN EXPOSURE is insignificant in affecting geriatric skin?
Brief Answer:
sun exposure affects skin in old age also
Detailed Answer:
Hello. Welcome again.
Sun exposure has cumulative effect on skin and body. I have never read so that in old age sun exposure doesnt affect skin.
Thanks
sun exposure affects skin in old age also
Detailed Answer:
Hello. Welcome again.
Sun exposure has cumulative effect on skin and body. I have never read so that in old age sun exposure doesnt affect skin.
Thanks
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. Shanthi.E
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