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I Had A Punch Biopsy Of The Nose Because The

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Posted on Tue, 4 Jun 2019
Question: i had a punch biopsy of the nose because the doctor thought i had a Basal Cell Carcinoma. i am concerned re the report which does not say i have a BCC but says i have eccrine three metaplasia.
what is this and can it become malignant.?
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Follow up: Dr. Dr. Rahul Kumar (0 minute later)
i had a punch biopsy of the nose because the doctor thought i had a Basal Cell Carcinoma. i am concerned re the report which does not say i have a BCC but says i have eccrine three metaplasia.
what is this and can it become malignant.?
doctor
Answered by Dr. Dr. Rahul Kumar (2 hours later)
Brief Answer:
Not carcinoma

Detailed Answer:
Hello
Thanks for the query and attached report.
Your report suggests that there is syringometaplasia and non necrotising granulomatous inflammation.
Syringometaplasia means that the cells of sweat glands in that area have changed to epithelial cells.
It is a benign condition and not a carcinoma.
Your treating doctor can remove the lesion completely.
If possible upload a photograph of the involved area.
This will help me in giving a closer diagnosis and better way of management.
Waiting for your response.
Just relax you are totally safe.
Let me know if you have any doubts.
Thank you
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
doctor
Answered by Dr. Dr. Rahul Kumar (0 minute later)
Brief Answer:
Not carcinoma

Detailed Answer:
Hello
Thanks for the query and attached report.
Your report suggests that there is syringometaplasia and non necrotising granulomatous inflammation.
Syringometaplasia means that the cells of sweat glands in that area have changed to epithelial cells.
It is a benign condition and not a carcinoma.
Your treating doctor can remove the lesion completely.
If possible upload a photograph of the involved area.
This will help me in giving a closer diagnosis and better way of management.
Waiting for your response.
Just relax you are totally safe.
Let me know if you have any doubts.
Thank you
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Dr. Rahul Kumar (7 hours later)
Hello, thanks for your answer. Could you pls explain what eccrine three Metaplasia is? That is the main part that concerns me.
Also, when I took the bandage off, it looked like the biopsy was a tiny but to one side of where the lesion was. I will upload before and after photos.
Can u tell by the report that this was in fact the correct spot? That is, it isn’t XXXXXXX skin from just alongside the lesion.
Pls can u answer these two questions.
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Follow up: Dr. Dr. Rahul Kumar (0 minute later)
Hello, thanks for your answer. Could you pls explain what eccrine three Metaplasia is? That is the main part that concerns me.
Also, when I took the bandage off, it looked like the biopsy was a tiny but to one side of where the lesion was. I will upload before and after photos.
Can u tell by the report that this was in fact the correct spot? That is, it isn’t XXXXXXX skin from just alongside the lesion.
Pls can u answer these two questions.
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Follow up: Dr. Dr. Rahul Kumar (7 minutes later)
I have tried to upload before the biopsy and after the biopsy photos- having trouble doing it. An u let me know if u received pls.
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Follow up: Dr. Dr. Rahul Kumar (0 minute later)
I have tried to upload before the biopsy and after the biopsy photos- having trouble doing it. An u let me know if u received pls.
doctor
Answered by Dr. Dr. Rahul Kumar (15 hours later)
Brief Answer:
Biopsy is taken from correct spot

Detailed Answer:
Hello
Thanks for the photographs.
1. Eccrine syringometaplasia means change of epithelial line of sweat glands.
This can happen due to a variety of reasons like exposure to sun or intake of a medication.
However this is a normal thing and can resolve on its own. In simple terms a cancer has atypical cells which means the cells are abnormally large or vacuolated while in metaplasia the cells are normal in size and appearance they are just changed from one type of normal cells to other type of normal cells.
2. The biopsy is taken from lower end of lesion which is a correct spot as it includes both normal and diseased skin for comparison under microscope.
Let me know if you have any doubts.
Thank you.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
doctor
Answered by Dr. Dr. Rahul Kumar (0 minute later)
Brief Answer:
Biopsy is taken from correct spot

Detailed Answer:
Hello
Thanks for the photographs.
1. Eccrine syringometaplasia means change of epithelial line of sweat glands.
This can happen due to a variety of reasons like exposure to sun or intake of a medication.
However this is a normal thing and can resolve on its own. In simple terms a cancer has atypical cells which means the cells are abnormally large or vacuolated while in metaplasia the cells are normal in size and appearance they are just changed from one type of normal cells to other type of normal cells.
2. The biopsy is taken from lower end of lesion which is a correct spot as it includes both normal and diseased skin for comparison under microscope.
Let me know if you have any doubts.
Thank you.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Dr. Rahul Kumar (19 hours later)
Hello, I’m not sure if the follow up question I tried to submit this morning went through as it doesn’t show up on our conversation thread- so excuse me if u already got it.
What I want to know is how can you tell from my photos that the biopsy was taken from the lower end of the diseased skin?
Worst case if the biopsy wasn’t from exact spot, could this diseased skin be other sun damaged (nose) skin & there really is a BCC somewhere close by that was missed?
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Follow up: Dr. Dr. Rahul Kumar (0 minute later)
Hello, I’m not sure if the follow up question I tried to submit this morning went through as it doesn’t show up on our conversation thread- so excuse me if u already got it.
What I want to know is how can you tell from my photos that the biopsy was taken from the lower end of the diseased skin?
Worst case if the biopsy wasn’t from exact spot, could this diseased skin be other sun damaged (nose) skin & there really is a BCC somewhere close by that was missed?
doctor
Answered by Dr. Dr. Rahul Kumar (9 hours later)
Brief Answer:
Not BCC

Detailed Answer:
Hello
Thanks for the follow up.
I can see a red patch on your nose and the biopsy is taken from the lower end of red patch.
BCC presents with ulcerated lesion and the skin is elevated with painless central ulcer.
Don't worry it's not a cancer.
Just relax.
Let me know if you have any doubts.
Thank you.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. Dr. Rahul Kumar (0 minute later)
Brief Answer:
Not BCC

Detailed Answer:
Hello
Thanks for the follow up.
I can see a red patch on your nose and the biopsy is taken from the lower end of red patch.
BCC presents with ulcerated lesion and the skin is elevated with painless central ulcer.
Don't worry it's not a cancer.
Just relax.
Let me know if you have any doubts.
Thank you.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Dr. Rahul Kumar (4 hours later)
That patch in the before photo was after the freezing and before the biopsy. The patch u can see is actually what remained after the freezing. It’s not a pic of the original lesion.
Can u be fairly sure biopsy was taken from lower end of the patch?
Is it at all possible that the skin biopsied and reported on was normal skin from alongside a lesion....or does the report suggest this is not possibly the case?
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Follow up: Dr. Dr. Rahul Kumar (0 minute later)
That patch in the before photo was after the freezing and before the biopsy. The patch u can see is actually what remained after the freezing. It’s not a pic of the original lesion.
Can u be fairly sure biopsy was taken from lower end of the patch?
Is it at all possible that the skin biopsied and reported on was normal skin from alongside a lesion....or does the report suggest this is not possibly the case?
doctor
Answered by Dr. Dr. Rahul Kumar (16 hours later)
Brief Answer:
Not cancer

Detailed Answer:
Hello
Can you send a photograph of the lesion with which you went for consultation.
One thing is definitely sure that it is not cancer, even if the biopsy was not from the correct spot.
Your entire nose appears totally normal.
There is no sign of cancer.
Let me know if you have any doubts.
Thank you.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
doctor
Answered by Dr. Dr. Rahul Kumar (0 minute later)
Brief Answer:
Not cancer

Detailed Answer:
Hello
Can you send a photograph of the lesion with which you went for consultation.
One thing is definitely sure that it is not cancer, even if the biopsy was not from the correct spot.
Your entire nose appears totally normal.
There is no sign of cancer.
Let me know if you have any doubts.
Thank you.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Dr. Rahul Kumar (10 hours later)
Thank you. This is very reassuring. I didn’t take a photo from before the initial consultation but I’ve found a close-up photo of my face from around the same time but I’m not sure if it’s of the spot we are talking about. I think it may be.
I guess what I was most interested in establishing is if in fact the biopsy was taken from a spot alongside the spot that was frozen, could the pathology report simply be referring to other ‘normal ‘ skin in transition that didn’t have a changed visual appearance on the surface to the naked eye, or is this unlikely given the report ie the report suggests it’s far more likely from a spot that was frozen and is now healing!
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Follow up: Dr. Dr. Rahul Kumar (0 minute later)
Thank you. This is very reassuring. I didn’t take a photo from before the initial consultation but I’ve found a close-up photo of my face from around the same time but I’m not sure if it’s of the spot we are talking about. I think it may be.
I guess what I was most interested in establishing is if in fact the biopsy was taken from a spot alongside the spot that was frozen, could the pathology report simply be referring to other ‘normal ‘ skin in transition that didn’t have a changed visual appearance on the surface to the naked eye, or is this unlikely given the report ie the report suggests it’s far more likely from a spot that was frozen and is now healing!
doctor
Answered by Dr. Dr. Rahul Kumar (5 hours later)
Brief Answer:
Nothing to worry

Detailed Answer:
Hello
Thanks for the follow up.
The biopsy report definitely suggests that there is a transition from normal skin however that is a common age related finding or happens in skin exposed to sun.
The relieving factor is that there is no cancerous change.
Just relax you are totally safe.
Feel free to ask if you have any doubts.
Thank you.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Dr. Rahul Kumar (0 minute later)
Brief Answer:
Nothing to worry

Detailed Answer:
Hello
Thanks for the follow up.
The biopsy report definitely suggests that there is a transition from normal skin however that is a common age related finding or happens in skin exposed to sun.
The relieving factor is that there is no cancerous change.
Just relax you are totally safe.
Feel free to ask if you have any doubts.
Thank you.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Dr. Rahul Kumar (40 minutes later)
Brief Answer:
Welcome

Detailed Answer:
Great to know that.
You are most welcome.

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Dr. Rahul Kumar (0 minute later)
Brief Answer:
Welcome

Detailed Answer:
Great to know that.
You are most welcome.

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Dr. Rahul Kumar (0 minute later)
Thank you, all good now. Appreciate your answers.
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Follow up: Dr. Dr. Rahul Kumar (0 minute later)
Thank you, all good now. Appreciate your answers.
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Dr. Dr. Rahul Kumar

Dermatologist

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I Had A Punch Biopsy Of The Nose Because The

i had a punch biopsy of the nose because the doctor thought i had a Basal Cell Carcinoma. i am concerned re the report which does not say i have a BCC but says i have eccrine three metaplasia. what is this and can it become malignant.?