Necessary to re-excise?

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8/19/2014 3:28pm
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Replies: 5

My son (age 9) had a spot removed from his heel. It was removed via punch and apparently was mildly atypical, but with margin(s) involved. The derm thinks completely unnecessary to re-excise. I am bummed there are margins (although thankful it is nothing)  Would it be overkill to take him elsewhere to re-excise? I have read that acral nevi on kids appear atypical under the scope anyways. It was 1mm,dark and on his sole? It's also painful to have a shot there, but will do it if need be! I'm not comfortable asking the derm to do it-- he really didn't even want to remove it in the first place. Another derm thought it was slightly atypical but she couldn't do a punch so I went to him. guess that backfired!!

curious12 - (8/19/2014 - 6:55pm)

Hi, i just wanted to add since I got the path report. It says MINIMAL cytologic atypia and extends to one peripheral margin. (Final diagnos- still says Mild Atypia) I'm feeling better about watching but would love input. Janner? : )

Janner - (8/19/2014 - 8:47pm)

Based on location and mild atypia, I'd be ok watching it.  If the pigment grows back, I know that I would probably re-excise, but I have had three primaries and high risk.  You should probably discuss with the derm if that happens.   It sounds like it really is totally benign and I've had shots in the heel and know they aren't fun.

curious12 - (8/19/2014 - 9:07pm)

Thanks--and absolutely if pigment grows back, it is coming off (I already told derm that and he said yes)
He just didn't think taking more off now was necessary. This isn't my "main" derm... but he will take anything off, does punches, sends to a good lab and gets results within 48 hours. Only thing I don't love is how casual he is.  I got a little panicky when I saw you had written that a biopsy can trigger something (I did a search on it) I suppose I could always ask the derm who said it should come off, for her opinion... but I probably should put it to bed! Thanks again  : )

Anonymous - (8/20/2014 - 5:30am)

"a biopsy can trigger something"

 

What does that mean?  That a biopsy can actually trigger getting melanoma?  What if you get a cut or just regular surgery, any kind of incisions/break in the skin can trigger something?

Anonymous - (8/21/2014 - 6:18am)

" I got a little panicky when I saw you had written that a biopsy can trigger something (I did a search on it)"

 

Can someone post the information about this (biopsy triggering something)