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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for benign lesions in the sweat glands

Answered by
Dr.
Dr. Kakkar S.

Dermatologist

Practicing since :2002

Answered : 8854 Questions

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Posted on Thu, 25 May 2017 in General Health
Question: Age:49, Gender: Female

Hello! I have what is essentially a "neurotic" question (I've asked quite a few here lately, seeing as i have a monthly subscription) regarding a lesion which my primary care doctor removed from the side of my face, in the temple area, about twenty years ago. It grew slowly, was firm but movable, about the size of a pea,
was flesh colored but had a bluish tint to it. My primary care doctor surgically removed it and sutured the incision. He sent it for pathology, and i remember asking him for the results but i do not recall what it was, i presume if it eas anything dangerous he would have followed up.

In doing some googling, i see there is something called a pilomatricoma, and that is exactly what it looked like, although I see that there are also benign sweat gland cysts as well.

I got a little nervous when i saw online that there can also be a cancerous form of pilomatricoma; again, i presume the biopsy report showed it was just a cyst.

Im attaching an image of the area of my face as it currently looks. You'll see a raised lesion that my dermatologist has diagnosed as an intradermal nevus. and to the left of it is a white hypopigmented and flat scar where the cyat was removed by my doctor twenty years ago. Is it safe to assume that the biopsy report probably indicated it was a pilomatricoma or a similar cyst and not some cancer related to that? I presume that if it had been cancerous there would definitely have been some changes to or reoccurrence in that spot by now? And that if it wasn't cancer and not adequatly removed there would have been some reoccurrence?

Thanks so much for your input on my crazy question (I have to stop googling these medical things!).
doctor
Answered by Dr. Kakkar S. 1 hour later
Brief Answer:
It was a surely a benign lesion

Detailed Answer:
Hello. Thank you for writing to us

I am dr.kakkar (dermatologist and venereologist). I have gone through your query detailing the past history and I have also viewed the Image.

I can see a skin colored raised lesion beside a hypopigmented scar of which I would keep a few differential diagnosis of intradermal nevus, a pilomatricoma, a dermatofibroma, a fibrous papule or a spitz nevus.

Pilomatrix carcinomas are very rare. They are locally aggressive tumors that have a tendency to recur, especially when they are incompletely excised. So if we believe that the lesion was incompletely excised twenty years ago, it would have definitely recurred till now. A flat silent hypopigmented scar for 20 years is proof that it was indeed a benign lesion.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kakkar S. 7 minutes later
Dr. Kakkar, thank you again so very, very much for completely addressing my questions and providing your reassurances...you are truly the best!!

Wow, I'm really "keeping you on your toes", with my crazy and neurotic questions lately! Please know that you have helped me so very, very much in easing my health anxiety....I cannot begin to thank you enough:)By the way, on another note, with regard to the raised lesion I have an appointment with a plastic surgeon later this week to have it removed, even if it's considered a cosmetic procedure. As you know, I've been obsessing lately over every mark on my skin lately and I will be glad to have it removed!
doctor
Answered by Dr. Kakkar S. 8 hours later
Brief Answer:
Your queries are welcome

Detailed Answer:
Thank you for writing to us. I am glad that I am helpful.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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