Re-Excision Skin Biopsy for Atypical Mole? Your Experience...

[Christine]

I'm posting here because next week I have to go back to my dermatologist and have a mole re-excised due to the pathology that came back after a shave biopsy on my back.

The closer it gets, the more nervous I'm getting...for a few reasons.

1. From what I can see online, the incision to get clear margins looks pretty HUGE to me.
2. Just healing from this stupid shave biopsy has been a pain, literally. It's in the center of my back, I can't reach it at all. I'm reliant on my husband being home to help me dress the wound and, based on our work schedules, he's hardly ever here when I'm needing to do this (in the morning after a shower). I had a couple of days where I couldn't get it done. Once I have stitches, I would assume the care is going to be more crucial.
3. I'm very nervous about the procedure now. I had forgotten that I have an an issue with epinephrine in the local numbing anesthetic and forgot to let the doctor know when he did the shave biopsy. Goodness, I was a jittery mess for about an hour after the procedure. I've called the nurse back to mention this and I felt like she didn't really quite get was I was saying and she came back and told me he doesn't use epinephrine and only uses lidocaine for skin surgery. But I'm telling you, I had epinephrine with lidocaine for the shave. Uuugggh, awful feeling.
4. I'm also allergic to most bandage and tape adhesives so I'm now dealing with the bandage rash on my back.

I'm really just sick of MYSELF!

Anyway, it might help if anyone has any stories of their experience (hopefully they are nice stories, but I'll take the ugly stories too). Sometimes I just do better if I'm mentally prepared.

 

[jalapeno_pretzel]

Do you know 100% for sure they are doing another surgical procedure? When I got called back in for an atypical result, she determined she had already taken it all out via the shave biopsy, and nothing further was needed. They let me know over the phone that she would check first and decide.

And yes, those shave biopsies are always worse to recover from than it seems like they should be! My last one itched like crazy for several days and I wanted to just yank the bandage off and scratch!

 

[michellev]

I have had a mole re-exised. Mine was also on my back. I was diagnosed with melanoma, so they wanted to make very sure that the margins were good. The re-exising was done during the same surgery where they took lymph nodes to determine if the cancer had spread.

This was 18 years ago. I am still so relieved that the cancer hadn't yet spread that I don't mind the scar. It is huge and ugly and still pulls and itches. The skin is really tight in that area.

I don't recall the healing process from it to have been too bad otherwise.

 

[Christine]

Do you know 100% for sure they are doing another surgical procedure? When I got called back in for an atypical result, she determined she had already taken it all out via the shave biopsy, and nothing further was needed. They let me know over the phone that she would check first and decide.

And yes, those shave biopsies are always worse to recover from than it seems like they should be! My last one itched like crazy for several days and I wanted to just yank the bandage off and scratch!

Yes, I know for sure. While the mole itself appears to be gone, based on my pathology, the shave biopsy didn't get enough normal tissue outside the margin of the mole. They can tell that from the pathology. So I have to go back and get clear margins. It's going to be a rather large incision.

 

[Christine]

I have had a mole re-exised. Mine was also on my back. I was diagnosed with melanoma, so they wanted to make very sure that the margins were good. The re-exising was done during the same surgery where they took lymph nodes to determine if the cancer had spread.

This was 18 years ago. I am still so relieved that the cancer hadn't yet spread that I don't mind the scar. It is huge and ugly and still pulls and itches. The skin is really tight in that area.

I don't recall the healing process from it to have been too bad otherwise.

Glad it all worked out for you. Mine did not come back as melanoma but as a severe atypical dysplastic mole. Now, when he goes back in to take out margins, there is a chance they could find melanoma but I'm hoping the odds to roll that way. At 54 I'm totally unconcerned with scarring or anything like that. I just hate all the itching and bandage rashes. It will be weeks of that. My coworker did tell me that he felt the stitched biopsies were just better to deal with than those shave biopsies which are like a shallow open wound.

 

[TheIncredibles!]

Even though the area is huge they might just need a very small area to take out so it might not be as bad as you think.

I also have issues with bandaids, tape etc. it was difficult when I had my biopsies and surgery for breast cancer. I had to use large nonstick surgical gauze coated liberally in aquaphor to stick onto my wounds then they stayed in place with my bra, my post surgical compression band and in one area an ace bandage. I felt like a mummy I have found that I do react better to those cloth bandaids over the plastic ones though. They irritate my skin but they do not cause itching.

Good luck!

 

[dhardawa]

I had it done a few years ago and it was no big deal. I had stitches, but no pain or extended care needed. For your back, you might get the big Nexcare bandages. You can put them on in the mirror and they stay put. I had two moles taken off my waist in the back and butt and had to kind of look in the mirror and aim. They’re big enough that you’ve got a decent chance of getting them where you need them.

https://www.amazon.com/Nexcare-Wate...spa?ie=UTF8&qid=1535503394&sr=8-2-spons&psc=1

 

[Cheetie]

Just had MOHS surgery last week. The area removed for clear margins was about the size of a nickel, but they have to extend the cut to be able to stitch. I’ve got eleven stitches in a line that’s about three inches long. Honestly, the stitches are easier to deal with than the open wound left from the biopsy.

I’ve been using gauze pads and cloth tape to cover the stitches because the adhesive in bandaids was irritating me. I second the idea for the big bandages with adhesive edges. I use those when I need the bandage to stay put for an extended period.

I was instructed to keep the original bandage on for 48 hours and not to shower during that time so be prepared for that. Once the stitches come out (two weeks from surgery) no further wound care is necessary.

 

[Christine]

Thanks. It's good to know that the stitches might be easier than the open wound. That whole area is one big ITCH and hives/wheals right now due to the bandaid (which I have not had on since last Friday). I have an outline of the whole bandaid in my skin and after a shower, it's just red, raised, and angry.

 

[OneOftheB's]

Thanks. It's good to know that the stitches might be easier than the open wound. That whole area is one big ITCH and hives/wheals right now due to the bandaid (which I have not had on since last Friday). I have an outline of the whole bandaid in my skin and after a shower, it's just red, raised, and angry.

This happens to me when I use band aids that are not the Band Aid brand. It's terrible to have additional issues due to medical supplies.

I had two moles removed 20 or so years ago that the dermatologist was worried about. He went ahead and did the whole subcutaneous route first go around, then one became infected he had to cut a larger area. It wasn't awful either time, just uncomfortable with the skin tightness. Good luck!

 

[wdwfan51]

Sorry you are going thru this. I had a similar thing on the back of my thigh. I recall the Dr saying he was taking the margins out the distance of the original mole above and below the site of the mole (so three times the mole size) and then the excision needed to be three times as wide for proper closure. So my .25 inch mole resulted in a .75 x 2.25 inch excision. Sounds miserable but it was better then the shave biopsy. After that first few days maybe you can leave the area uncovered so you won’t need help. Ask the Dr office for advice on wound care. Best wishes on a speedy recovery.

 

[Wishing on a star]

I am so sorry that you have to go thru this!

I know what it is like to have something like this done on your back, where you can't reach.
I had something similar - but no melanoma... just errant tissue.
It was awful!!!
And I also have a limited range of motion and pain in my arms/shoulders, etc.
No way I could reach it.

I do have one suggestion:
If your husband is just not home and available to assist you in dressing and caring for this - I would talk to somebody, and even go in person, to see if they can request that they get your insurance to pre-authorize and cover wound care.
I am hoping that there is a walk-in clinic, or your local doctor, nearby. And they could take care of this every day.
That, along with some assistance when your husband is home, should help alleviate some of the pain and itching????

I would want to make sure that all of this was addressed, along with your issues with sensitivities, before you go in for the procedure.

I also had a mole removed on my back, some years ago, and they did put like 3 stitches.
they used that heavy, like fishing line, thread for the stitches.
one of the ends that were left when they trimmed off, where it was tied, got twisted around and was actually poking into the wound like a needle.
I went right in, and told them that I needed to see somebody ASAP, that something was wrong.
Thank goodness there was the other dermatologist there that day, and she was able to fix it up!

I am sending my well-wishes and sympathy!!!!

 

[Christine]

I am so sorry that you have to go thru this!



I do have one suggestion:
If your husband is just not home and available to assist you in dressing and caring for this - I would talk to somebody, and even go in person, to see if they can request that they get your insurance to pre-authorize and cover wound care.
I am hoping that there is a walk-in clinic, or your local doctor, nearby. And they could take care of this every day.
That, along with some assistance when your husband is home, should help alleviate some of the pain and itching????

I am going to stay home and telework the two days after the procedure. If worse comes to worse, my parents are close by and I can get them to do it. After those two days, it will then be the weekend. So maybe I'm covered. Otherwise, once I return to work, I'm showering at 4AM and in the car by 5AM with my carpool. There's no going to any clinic and I can't change my hours either. But, based on what I'm reading here, there's a good chance that maybe I can go bandage free by day 5.

 

[kirstenb1]

I don't have experience with this, but could you shower at night instead? Would that work with your husband's schedule? I know it's not ideal. Good luck with your recovery!

 

[Pea-n-Me]

If it were me, I'd probably put a Tegaderm over it for a few days, then take that off and leave it open to air. Idk if they'll do this for you, but you could ask the doctor about it, just explain your situation. Tegaderm is like an artificial skin.

 

[Christine]

I don't have experience with this, but could you shower at night instead? Would that work with your husband's schedule? I know it's not ideal. Good luck with your recovery!

Yeah, I've already thought I might try something like that. I think when I had the shave biopsy, they wanted a bandage change two times a day so I thought I might need to do that also. Further reading of the instructions looks like, because of the stitches, I may only need a once a day change.

 

[Christine]

If it were me, I'd probably put a Tegaderm over it for a few days, then take that off and leave it open to air. Idk if they'll do this for you, but you could ask the doctor about it, just explain your situation. Tegaderm is like an artificial skin.

Pea-n-Me: My friend used this on his mole removal also. I know that you are a nurse so maybe you have experience with this but doesn't this have some form of adhesive on it. Would it not cause the adhesive reaction also? I have been reading about Tegaderm on the net and it seems that the Tegaderm HP specifically gets a good review from those prone to adhesive reactions.

 

[Feralpeg]

I had it done on my back twice. Both times, it turned out to be basal cell carcinoma. The incisions weren't small, and I have a couple of good sized scars. I also had it done on my face. Same thing...basal cell. Fortunately the spot was right next to my nose and is not terribly noticeable.

 

[Pea-n-Me]

How did you make out, Christine?

Pea-n-Me: My friend used this on his mole removal also. I know that you are a nurse so maybe you have experience with this but doesn't this have some form of adhesive on it. Would it not cause the adhesive reaction also? I have been reading about Tegaderm on the net and it seems that the Tegaderm HP specifically gets a good review from those prone to adhesive reactions.

Sorry late to respond to this. There is an adhesive but idk if you'll react to it. I've seen people sometimes have a mild redness when it comes off, but I don't recall any major reactions.

 

[Christine]

How did you make out, Christine?


Sorry late to respond to this. There is an adhesive but idk if you'll react to it. I've seen people sometimes have a mild redness when it comes off, but I don't recall any major reactions.

Hey, thanks for checking back!

I had the excision Wednesday afternoon and did okay (I suppose!!). The doctor wasn't overly thrilled about using a local anesthetic without epinephrine. I told him that I wanted *him* to do the best and I'd suffer through any ill effects from it. Before I went I took .25 mg of Xanax. This did nothing to stop my heart pounding while they were doing the excision but I actually think it did tamp down the worst of it. The best part was that, this time, I didn't seem to have the shakes later due to the epi and I think the Xanax may have worked in that regard. Who knows.

Anyway just dealing with the stitches now in a very uncomfortable place. I can't really reach for anything nor sit back against anything. Sleeping has been a challenge.

Right now I'm using either the Nexcare Sensitive Skin Pads with adhesive around it or using my own pad and putting Nexcare sensitive skin tape on it. My own combination seems to be more comfortable so I'll stick with that. When it gets removed, the skin is really red, but I don't think I see signs of the bumps/hives yet so that's good. I've only got 10 more days of this.