Another Day

Another Doctor....

Ready for another M.D. lesson? Today we get to learn about melanomas. Because I apparently had one... right smack dab on the middle of my forehead. Kind of makes me laugh that it was put there to get my attention. Pretty much that is what it takes these days to make it to my radar and the top of my To Do list. After a couple months of being annoyed by the black spot that had suddenly appeared and freaked me out every time I saw it in the mirror, I grabbed my cell at a red light and called the dermi. They booked me that afternoon. We scraped that sucker off pretty much for vanity's sake; lo & behold, it came back suspicious. It got sent back for another diagnostic and I was called in for the official sit down discussion today. The Dr. said it's a "melanoma that isn't really a melanoma" OK.......

Junctional Melanocytic Proliferation, within a Solar Lentigo (forehead)
(a melanoma in situ arising in a solar lentigo and a junctional nevus associated with one).
Whatever that means.

This represents one of the earliest stages of melanoma with the atypical melanocytes limited to the dermal-epidermal junction and with no evidence of dermal involvement. Depending upon the morphology, some dermatopathologists subclassify these melanoma in situs as:

Lentigo maligna
Melanoma in situ, superficial spreading type
Melanoma in situ, acral lentiginous type

A melanoma in situ stage does not exist for a nodular melanoma, which by definition, is in the vertical invasive growth phase. Desmoplastic melanomas, likewise, do not have a recognized precursor in situ lesion. However, lentigo malignas may give rise to this type of melanomas. Because this melanoma is a precursor lesion to a later invasive lesion, complete excision is curative.

So, basically, if I understand this correctly, I don't need to freak out, but I do need to count "freckles" yes, I know they're NOT FRECKLES and anything that suddenly pops up on my skin is going to be cut out. All this I gleamed when I asked, "didn't y'all count those at my skin check?" I mean, I don't pay attention to this stuff and I know I heard a bunch of weird names and numbers rattled off! She looked at me like I was addled. "Honey..." she goes, "we aren't counting, we are looking for certain things, and they're not freckles-they're MOLES. You're over 45, so ANYTHING that 'pops' up you need to tell me about because it's not bad unless you don't follow up. We're gonna be girlfriends now, and see each other every 3 months. Don't worry, it'll be OK!!" Then she went on to draw all over my forehead debating the best way to not disfigure me for life when she carves out a 5mm margin of where the previous "freckle" used to be to so they can look at the surrounding tissue to see what was around it and if it spread. If I'm lucky I get a forehead lift or botox or something. December 6th... I can hardly wait. December 13th the stitches come out and I get the new & improved Body Scan. Oh yeah, and a new girlfriend.