Little Spot on Thumb Causes Large Amount of Confusion

Last updated: February 2021

A tiny little hole on my thumb, above my knuckle, has caused a degree of hassle that is greater than you would expect for something the size of a pinprick. I remember having something done to it a while back and ending up with one stitch. I thought maybe it was a Mohs, but at my last dermatology appointment, the doctor said it had just been a biopsy that came out negative.

A Mohs or biopsy for my squamous cell?

She was not my regular dermatologist but had been the one available to see me when I was worried about flakey spots elsewhere that I thought were squamous cell cancers. (They were, and more Mohs is on my schedule). I thought my regular dermatologist had recommended a Mohs that I thought was performed on my thumb, but as the recent doctor was looking at my chart, she said that no, there hadn’t been a Mohs.

If this sounds a little confusing, that’s because it is. So maybe I should spell it out. We’ll call the one from my most recent visit Doctor A, and the second one in the sequence, my regular dermatologist, Doctor B. Dr. A said I did not have a Mohs and gave me the time-honored “let’s watch it” advice. I thought Dr. B had sent me for Mohs but Dr. A said not so.

A possible squamous cell carcinoma on my thumb

It’s been about a month, and I’m scheduled to see Dr. B in a few weeks. I’ll be glad to see her and get it straightened out. I think the spot is getting a little bigger, so I imagine I’ll end up with another biopsy.

Irregular bleeding

Also, it has been behaving oddly. For example, over the summer, a tennis ball hit my hand when I was out on the court. It happened to hit my thumb, right on the spot. Blood spurted out. Someone gave me a Band-aid. If you know anything about me, you will know that I continued to play. We all know that it is not normal to go around having a finger that spurts blood.

Irritation from holding hands

Here’s something else. My boyfriend reaches out to hold my hand and doesn’t remember that my thumb is sensitive. I wiggle my hand to set my thumb loose so it doesn’t feel the pressure. Maybe he thinks I’m shaking him off as a pitcher would a catcher, but actually I’m just setting my thumb free so it doesn’t get irritated.

Or, is it graft vs. host disease?

To confuse the matter further, a physician’s assistant who I see for another problem, says its behavior could be due to something other than skin cancer. It’s a syndrome called graft vs. host disease (GVHD) of the skin which I developed after my last stem cell transplant.

It occurs when the graft, my donor, messes with the host, the recipient, and causes the skin to get funky in different ways. Part of it involves difficulty healing. So the PA told me it could be a cancer-free spot that just has difficulty healing.

Better to be safe than sorry This is all part of what happens when you mix a history of leukemia and the side effects of treatment with the ongoing battle against squamous cell cancers. As I have said previously, allogeneic stem cell transplant with the cells coming from the donor, add to the risks of SCCs for survivors like myself.1This all amounts to the need for constant vigilance, to say something if I see something. I sure have a lot to say about the thumb!

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