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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What do the following test reports indicate?

Answered by
Dr. Asmeet Kaur Sawhney


Practicing since :2007

Answered : 3699 Questions

Posted on Mon, 27 Mar 2017 in Skin Hair and Nails
Question: Hello... I tend to have a lot of health anxiety and am very conscious about racking my skin. I see the dertmatologist for yearly skin cancer screenings, and just recently had one with nothing suspicious found. I'm attaching a picture of a very tiny mark on my back, slightly below my arm (probably about one mm if that) that resembles a pick mark. Is that anything to be concerned about? I tried to point it out to my dermatologist, she couldn't even see it, and said that nothing in that area looked concerning.

Also, back in 2000 my primary care doctor removed some spots from my back using electrocautery and curettage. He said that they weren't moles, although they were pigmented (maybe seborrheic keratosis?) and there were no biopsies done. I had a skin cancer screening by a dermatologist shortly before they were removed, and that doctor had said they were all normal. It is. Ow seventeen years later and all that remains is lightened areas is skin (hypopigmentation??) where the spots were removed, I've attached an image. One of those whitish spots feels somewhat "looser" than the surrounding skin, almost like I could scrape it off. Again, my dermatologist said here's nothing concerning there. Is it normal to have a spot of hypopigmentation appear that way? Thank you!!
Answered by Dr. Asmeet Kaur Sawhney 2 hours later
Brief Answer:
Everything is normal, no need to worry

Detailed Answer:
Thanks for being at HealthcareMagic
I have gone through your complaints as well as reviewed the attached photographs.
I can appreciate few hyperpigmented lesions and hypopigmented areas.
They seem to be perfectly fine.
Even hypopigmented area after electrocautery is normal.
It is due to post inflammatory hypopimentation.
So there is no need to worry.
Dr Asmeet
Above answer was peer-reviewed by : Dr. Prasad
Follow up: Dr. Asmeet Kaur Sawhney 43 minutes later
Hello Dr. Sawhney -- thank you so very much for your expertise and reassurances.

So you don't feel any concern about the tiny "pockmark"? It has been there several years with no changes.

Also, with regard to the white spots of hypopigmentation from electrocautery, as I said, one of those spots has an almost "looser" feel to it (for lack of a better word) than the surrounding skin -- is that normal?

Finally, one last question -- with regard to the spots on my back which my doctor removed by electrocautery and currettage back in 2000, no biopsies were conducted. He had examined all of the lesions, said they were normal, and I had had a prior skin exam by a dermatologist who said they were normal as well. Is it safe to assume that, since a biopsy was not conducted, everything is fine in those spots, as they now continue to be just hypopigmented areas with no other changes occurring, pigment returning, etc. seventeen years after having them removed?

Thank you again so very much for answering my (neurotic!) questions and for your reassurances doctor!!
Answered by Dr. Asmeet Kaur Sawhney 7 hours later
Brief Answer:
Pock marks, hypopigmented areas and loose mark are all normal,

Detailed Answer:
I don't think there any need to be concerned about the pock mark as well the hypopigmented areas as they are present for a long time and are not showing any changes in appearance.
Looser spot must be an atrophic hypopigmented scar which is quite common after electrocautery. It is normal occurrence in some persons.
Biopsy is usually recommended for doubtful lesions. Most of the times diagnosis of seborrhoeic keratosis and moles is clinical without going for any invasive investigation.
Since your spots were examined clinically and they were found to be fine at that time, there is no need to worry about them as they were all benign lesions.
Relax and don't stress about them as everything is fine.
Above answer was peer-reviewed by : Dr. Yogesh D
Follow up: Dr. Asmeet Kaur Sawhney 15 minutes later
Dr. Sawneybyiubhave truly been a godsend in easing my mind and I cannot thank you enough.

If I can bother you with one last (neurotic) question...I have been diagnosed with sebaceous hyperplasia in my face and I also have numerous Fordyce spots inside my cheeks and in my lips. I made the mistake of googling these conditions and ran across information saying that they could be a marker or related to Lynch Syndrome and Muir Torre disease. I understand those syndromes are rare and sebaceous hyperplasia and fordycebapots are common. Is there any definitive link between them and do you feel I have anything to worry about? There is no cancer in my family, I just had a routine colonoscopy which was clean, and I have annual mammograms and Pap smears all normal.

(Ps I will not be consult By "dr. google" anymore after this!!)
Thank you again for your kindness Dr.!
Answered by Dr. Asmeet Kaur Sawhney 10 hours later
Brief Answer:
Sebaceous hyperplasia & Fordyce spots usually not associated with cancer

Detailed Answer:
Sorry for the delayed response.
Muir Torre syndrome is a rare subset of hereditary nonpolyposis colorectal cancer ( HNPCC ) representing 1-2 percent cases of HNPCC.
It is suspected in persons with multiple benign sebaceous tumors other than sebaceous hyperplasia.
A sebaceous carcinoma may represent as a marker of the syndrome.
There is no need to worry as Fordyce spots and sebaceous hyperplasia are not associated with increased risk of internal malignancies.
Moreover your family history and colonoscopy are also fine.
Relax and don't stress yourself.
Above answer was peer-reviewed by : Dr. Kampana
Follow up: Dr. Asmeet Kaur Sawhney 2 hours later
Dr. Sahwney, again, I cannot thank you enough for your compassion and reassurances in answering my (hypochondriac-related) questions and concerns. Please know that you have eased my mind completely and have helped me immensely. You truly make a difference in people's lives most definitely in what I can only imagine is your incredible bedside manner, but also in this forum, by so expertly and compassionately addressing people's questions!

I've dealt with mild health anxiety my whole life, but unfortunately lately I think that hormonal swings due to peri menopause are exacerbating it. I'm currently taking cymbalta and Xanax (Xanax only as needed for breakthrough anxiety), which certainly helps. As I indicated, to make matters worse, I google these conditions and assume and imagine the worst case scenarios. This has been a wonderful forum for putting my mind at ease, and I've actually subscribed to the monthly plan so that I can take full advantage and not be bothering my doctors with unnecessary visits.

Thank you again so very very much and God bless you!!
Answered by Dr. Asmeet Kaur Sawhney 2 hours later
Brief Answer:

Detailed Answer:
All the best!!
Feel free to ask your queries.
Above answer was peer-reviewed by : Dr. Raju A.T

The User accepted the expert's answer

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