I have a pimple size bump between lip and right nostril. My elderly dermatologist said it is sebaceous and another younger dermatologist cosmetic surgeon last week said it was suspicious. It is white and over time has had some peeling dry skin around it. Once or twice I accidentally scratched it or pulled the dry skin and it bled. Now it seems to be getting smaller. If if goes away on its own can I trust it is not cancerous in nature? I have had this for 6 to 12 months, I think.
Will a Cancerous Growth Disappear, I.e. Basil Cell Go Away on Its Own? Can a Plastic Surgeon Diagnose Skin Cancer? (photo)
Doctor Answers 1
Skin Cancer Diagnosis: A Conundrum?
Thank you for trying to take a photograph. It's amazing how many patients come in with pictures of their skin problems and the pictures are tremendously helpful. Unfortunately, in your case, at least as I see the photo, it is not helpful to me. The picture is blurry and from it I have no way of telling whether this is a skin cancer, basal cell carcinoma or otherwise.
That leads to some general responses to your questions. Different physicians have different experience with diagnosing skin cancer. Some have seen countless numbers and others less so. It is not surprising that two or more physicians have different responses on how you should proceed. With that as a caveat, I can only add my own general protocol to the mix. I have seen numerous skin cancers appear to get bigger and smaller over time, so the fact that a lesion appears to be "improving" is not adequate for me to proclaim it benign. If I look at a lesion and it fits the picture of a basal cell or squamous cell carcinoma (or other tumor), I think one has no choice but to biopsy it. Now, mind you, if it looks like a pimple or cyst or benign wart, we may proceed accordingly. But if its suspicious, and particularly if it is suspicious and persists after a month or so, then I would opt for a skin biopsy.
Skin biopsies, in general are easy to do. Depending on the location, they usually leave only a small scar and the scar is worth the reassurance that a cancer doesn't lurk beneath the surface. The only other thing I would like to add is that in your case you have two different physicians who express different degrees of concern plus your lesion has bled and persisted for quite a while. The only way you can really know who is correct and what you have is by a small skin biopsy.
I hope this give you at least one dermatologist's general approach to skin lesions. Good Luck!
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