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Suggest Treatment For Oral Candidiasis While Having Malignant Melanoma In Armpit

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Posted on Fri, 17 Jun 2016
Question: Hello! My husband was diagnosed with stage 3B malignant melanoma on his left side just below the armpit in 2008. He underwent surgery, 30 days of interferon into a port and 8 months of interferon injections that he gave himself. At that time, his upper lip became red, swollen and extremely painful. His doctors prescribed some ointments and eventually, the symptoms disappeared. Fast forward to 2016. We went to Hawaii in March and within 5 days he came down with a terrible cold with lots of coughing and coughing up phlegm. When we returned home, a chest x-ray was done which ruled out pneumonia but he was prescribed prednisone for the inflammation in his lungs. He's since completed the prednisone treatment, but has now developed the same sore upper lip that he had before. It's very red, appears to have some small white patches and excruciatingly painful. He found some of the ointments that were prescribed for him prior, but it's not clearing up and actually appears to be getting much worse. He put some over the counter aquaphor on his lip last night and had to remove it immediately because it burned so badly. Could this lip reaction be a result of the prednisone treatment, being out in the sun with sunblock on while in Hawaii, or is it possible that the melanoma is coming back? He sees his dermatologist every 6 months and has received a clean XXXXXXX of health since the cancer treatment - for which we are very grateful!
doctor
Answered by Dr. Shuba hariprasad (2 hours later)
Brief Answer:
Oral candidiasis

Detailed Answer:
Hello Ms. XXXXXXX
Thank you for your query

I'm Dr. Shuba Hariprasad and will be answering your query today.

I appreciate your detailed and precise query.
Based on this, I suspect candidiasis /thrush which can be associated with an illness or immunosuppressive therapy like steroid (prednisone).
His prior history of cancer, slightly increases his predisposition to these fungal infections.

I would :
-clinically examine him to assess the extent of the Infection
- and endoscopy, if indicated (esophageal candidiasis suspected)
- may need a tissue examination (of the patches)

Based on the this, he may require oral and local antifungal therapy. This may be required for a longer than usual duration, even upto 2 weeks to a month.

I urge you to see his doctor right away to confirm and treat.
In the meantime, do not apply any medications.
Cool compresses and cool water (not ice cold) will help soothe burning and pain.
Avoid sunlight, hot fluids/food

Hope this helps.
I would be happy to help, if you have any questions or would like further clarification.

Wish you both good health.

Regards,
Dr. Shuba Hariprasad
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Shuba hariprasad (22 hours later)
Thank you for your prompt response. I half suspected it would be the candidiasis. We will get him to his dermatologist for the proper treatment.

On a different issue, I myself have had 2 serious mouth injuries in my lifetime, one when I took a header off a moped and landed right on my mouth, knocking out my front teeth and needing 6 stitches into my lower lip. Another time, I somehow managed to trip over the cat and again landed right on my mouth. No lost teeth this time, but I did split open the inside of my lower lip. I probably should have gone for stitches then too, but I didn't. the first accident occurred over 30 years ago and the second accident about 13 years ago.

Now, over the past 6-9 months, I've noticed a small black spot on my lower lip. It's just flat - not raised - and black, no pain and but now my lipstick won't cover it - it shows right through. I pretty much assumed it was some kind of scarring that's decided to show. Does this sound like anything to worry about?

Thank you! I appreciate your wonderful advice!
XXXX
doctor
Answered by Dr. Shuba hariprasad (42 minutes later)
Brief Answer:
Probably benign, better to get it checked

Detailed Answer:
Hello,
Thank you for the follow up.

Your description of the lesion sound like it is a benign macule. If it lies over the area of injury, it is probably a scarring response on exposure to sun.
This can occur even years later.

I, however, like to be on the cautious side and recommend that you consult a physician. If it looks suspicious, a tissue test will help put our minds at ease at the least.
Catching a cancer in the early stages has a much better prognosis and recovery.

Please use sunscreen lip balms to prevent further darkening. Monitor the size and texture regularly. Any changes over a short period should caution you to seek an immediate consult.

Hope this helps.
Please let me know if there is anything else I can help you with.

Wish you both good health.

Regards,
Dr. Shuba Hariprasad
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Shuba hariprasad

General & Family Physician

Practicing since :2002

Answered : 1087 Questions

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Suggest Treatment For Oral Candidiasis While Having Malignant Melanoma In Armpit

Brief Answer: Oral candidiasis Detailed Answer: Hello Ms. XXXXXXX Thank you for your query I'm Dr. Shuba Hariprasad and will be answering your query today. I appreciate your detailed and precise query. Based on this, I suspect candidiasis /thrush which can be associated with an illness or immunosuppressive therapy like steroid (prednisone). His prior history of cancer, slightly increases his predisposition to these fungal infections. I would : -clinically examine him to assess the extent of the Infection - and endoscopy, if indicated (esophageal candidiasis suspected) - may need a tissue examination (of the patches) Based on the this, he may require oral and local antifungal therapy. This may be required for a longer than usual duration, even upto 2 weeks to a month. I urge you to see his doctor right away to confirm and treat. In the meantime, do not apply any medications. Cool compresses and cool water (not ice cold) will help soothe burning and pain. Avoid sunlight, hot fluids/food Hope this helps. I would be happy to help, if you have any questions or would like further clarification. Wish you both good health. Regards, Dr. Shuba Hariprasad