Tiny Volcano Thumb Goes to the Dermatologist

Last updated: July 2022

“She just makes squamous cells,” my dermatologist said to the resident as the resident froze a pre-cancer on my neck.

Squamous cell carcinoma on my thumb

I guess that makes me sound like a squamous cell carcinoma factory, but in a way, that’s what I am. The good news is that I am watched so carefully. The bad news is that there always seems to be something to treat. That means either getting a spot frozen or biopsied or being told that I need to treat or re-treat whole areas with the combination of cream and calcipotriol plus 5-fluorouracil (5-FU). that I use instead of just plain fluorouracil. It means that more times than I can count, the biopsied spot needs Mohs surgery.

This wasn't an emergency, but I also didn't know if it was a big deal

My recent visit to Dr. Lin at Brigham Dermatology Associates in Boston was for a quick look, not a regular appointment. I wouldn’t call it an emergency, let’s say it was special. The reason was a tiny spot on my thumb. I’ve written about it before. I had Mohs surgery on a squamous cell cancer on my thumb longer ago than I can remember. But it never totally healed. If something brushes against it, it spurts a little blood. It’s my tiny volcano thumb. Now, I’ve heard and read enough to know that a spot that won’t heal, or that won’t stop bleeding, is cause for concern. So I got the special appointment in between regular appointments.

My doctor doesn't seem too concerned

Dr. Lin didn’t seem too concerned, but she biopsied it again. Now I have one tiny stitch in the tiny little hole. A few days after the biopsy, it was already starting to feel better. But the first day or so, it hurt quite a bit. This made it an occupational hazard when it comes to writing. And since writing is what I do, I couldn’t get much done for a couple of days. I didn’t want to cause even more problems by banging my thumb on the keyboard. Plus, it was “telling me” not to use it by the way it was hurting when I typed.

In a past life, this would've been a big problem at my job

I thought about how lucky I was to work as a freelance writer and not in a newsroom anymore. At the daily newspaper where I was a reporter, pity would have been nonexistent. People dragged themselves into the newsroom when they were not feeling well all the time. Obviously, this is not a good thing to do: They were just spreading germs. But editors and reporters operated with the understanding that you did not want to have someone do your work. This alone is valiant, but the spreading germs part is stupid. Also, if you whined, you were deemed a wimp.

This squamous cell carcinoma is an occupational hazard

At home with no deadlines, I could at least baby the thumb. I don’t know if there is some remaining squamous cell carcinoma lurking there. Maybe it’s just a hard-to-heal area. It does get in the way of things, that's for sure. One time over the summer, a wayward tennis ball hit it. The tiny volcano erupted, and I had to take a break from our tennis clinic to find a bandage.

I’ll find out in a week what the story is. At least, bandaged, it can’t get into too much trouble, and it calmed down enough for me to type this post.

What is the most inconvenient place on your body that you've had skin cancer?

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