A sitting woman surrounded by question marks looks concerned at a spot on her leg.

Fooled by a Spot that Didn't Look Like a Squamous Cell

So, my squamous cell radar was finally off.

A spot that I thought wasn’t a squamous cell carcinoma actually was one. But I wasn’t the only one fooled. A dermatologist said it looked like a scab. This one little spot sure gave me the runaround.

What does squamous cell carcinoma look like?

It was on the right side of my right knee and was as small as a freckle. But it was raised. The color threw me off. My squamous cell cancers have presented as tiny spots that won’t stop flaking. They are not any darker than the rest of my skin. This one was dark. Because it was dark, I jumped to the conclusion that it was a melanoma. I have no idea why I thought that. In any case, I didn’t like the looks of it, so I did the smart thing: I picked at it.

Not. As in, not smart. Picking will only irritate a spot, not make it go away, but my inner picker took over.

Incorrectly diagnosed as a scab

I showed it to a dermatologist. The doctor said it looked like a scab and advised leaving it alone. I did leave it alone, but it didn’t go away. Months passed and I had a visit with one of my other dermatologists. She said the same thing: It looked like a scab, and I should leave it alone.

To back up, in case you’re wondering why all these dermatologists, I have three sets of dermatologists, and within each practice, a number of dermatologists. One is for my skin in general, one specializes in subcutaneous dermatology (looking at the innermost layer of skin), and one is my Mohs surgeon.

Telehealth and delayed biopsies

It had been there for months when I had my first telehealth visit. It was with the doctor who specializes in subcutaneous dermatology, but she can also do a general visit. I showed her the spot. She said she would have biopsied it if I were coming into the office. But since I wasn’t planning on going in, there would be no biopsy.

Could it be melanoma?

The Mohs people like to stay in the loop. I sent them a photo of the spot. The next day, I got a call. They wanted me to come in for a biopsy. I asked when. They said the next day. The NEXT DAY? I was pretty sure they were worried if they wanted me to come in the next day. Must be a melanoma, and not only that, a deadly one.

Jumping through hoops for a biopsy

The Mohs surgery center is in a hospital in Boston, 90 miles from home. Arranging transportation in a day under normal circumstances is difficult. My boyfriend was the only one who could take me. At this point, Boston was a hot spot, and he didn’t want me to go. I called a local dermatologist, to see when I could get in. It would be a couple of weeks. That didn’t seem bad, but it was only for a consult, not a biopsy.

I was nervous and wanted to get it done. He agreed to take me. The hospital felt safe. A person greeted me with a temperature check and a mask that she extended to me from the edge of a pole. I got the biopsy and went home. I waited the usual eight or so days for the results.

Surprise: squamous cell carcinoma

It was a squamous cell carcinoma. I wouldn’t need a Mohs surgery because the biopsy had taken care of it. I was surprised that my squamous cell radar had been off, and I was relieved that the spot was finally gone.

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