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Melanoma on hand. Need some advice
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Anon_237102 posted:
Hello. I've been diagnosed with melanoma on my the top of my hand, and two suspicious 'freckles' which will also be removed with the Mohs procedure at the same time (they are about a 1/4 out on each side of the biopsy site.

Because the melanoma was raised I have to have deeper pathology done and will have to wait until the next day for the skin graft. If there are cells under my skin then a hand surgeon will be operating with the dermo surgeon.

My head is swimming with questions. Has anyone here ever had a melanoma removed from their hand? Where will they take the skin graft from? It's on the same hand I use and I'm wondering if you have had this done, have you had loss of feeling or mobility?

My melanoma was 'atypical' in that it didn't meet the characteristics common with a melanoma. In fact, the dermatologist who biopsied it didn't think it was anything to worry about but because my mother died of metastatic basal cell skin cancer, he did the biopsy. The only thing 'different' about it was that it suddenly raised up. Before that, during my yearly skin screenings my doctor didn't think it was more than a freckle. But beecause it is on my hand, I kept noticing it and noticed that it had raised up.

I was told by the dermatologist that my risk for repeat melanomas is now pretty much the case. I'm pretty much scared at this point. Any help would be very much appreciated.
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millicentbash responded:
PS - I have also been diagnosed with actinic keratosis, widespread, on my face. I was supposed to start a special cream (Carrac?) for three weeks. I've been told to hold off on this until my hand surgery is finished.
 
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Anon_160335 responded:
I hope by now you have had the skin graft and you are feeling much better. Did they get the graft from you back?

I have a friend that had one melanoma 10 years ago and that is the only one he has ever had.
 
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millicentbash replied to Anon_160335's response:
Hello again.

I am now on the mend after having a large split skin graft applied to the top of my hand on Aug. 29. i had the mohs procedure as well as further pathology to declare 'all clear' on all areas which was very good.

I ended up with a very large defect on the top of my hand that required a skin graft taken from my outer thigh. It was a split skin graft.

I just learned that split skin grafts that are 'meshed' before application are not recommended for the top of the hand because they have a higher rate of contracture.

I'm hoping that someone who has had a split skin graft like this can fill me in on their results and are they pleased with the results.
 
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An_239994 responded:
I had Clark Stage IV on the top of my head. I understand your concerns since I had similar diagnosis. The graft will typically come from a location out of site (leg area). I had them take it from my left groan area. My Melanoma was rather deep so I had to have my Lymph nodes examined by isotope. I thank the Lord that the nodes were negative and the margins were clear when the melanoma was removed.
Take a look at this link it will answer alot of your questions best of luck and God Bless you.http://www.whcenter.org/body.cfm?id=555587&action=articleDetail&AEProductID=Adam2004_10&AEArticleID=000032&crawl=false
 
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Skin Cancer Foundation
Michael W Steppie, MD responded:
I frequently get asked about the final outcome of a surgery. Melanoma can occur in any location of the body. After sections of tissue from a biopsy of your skin are assessed under a microscope by a dermatopathologist and determined to be melanoma, your dermatologist will discuss several treatment options. Treatment of Melanoma is designed, according to several variables including location, extent of spread and aggressiveness of the tumor as well as your general health. Forms of treatment for melanoma include surgical excision, Mohs micrographic surgery, chemotherapy, and radiation. Sometimes lymph nodes are removed. Your dermatologist will help you to better understand these treatment options.

You are the best defense against skin cancer. Perform monthly skin examinations of your entire body and watch for unusual marks or changes to your skin. We recommend regular skin exams by a dermatology professional and even more frequently if you have been diagnosed with a skin cancer.
 
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rebecca3380 replied to Michael W Steppie, MD's response:
My brother had a large mole removed off of his abdominal area by his ribs, two dermatologist had told him it was nothing to worry about, it was a level four melanoma, they removed the mole but did not check the lymph nodes he did interferon treatment for six months but during an exam they found swollen lymph nodes under his arm. Had a pet scan done and discovered he had melanoma in his thigh bone and hip, they removed the lymph nodes and two of the six came back as melanoma. The next month it was found in his spine and the next month it had spread to his liver and lungs with in two weeks it traveled to his brain and two weeks later he passed away at the age of 48. My question is if they had not removed the mole would all of this had still happened?
 
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millicentbash replied to rebecca3380's response:
Hello Rebecca. First off, I am very sorry that your brother has passed away.

You ask if they had not removed the mole would all of this has still happened. Since I've been a melanoma patient, I will tell you what I was told and what I have learned through research.

I'm sorry to say that from what I've read and heard from my doctor that removal of the mole (which now would be referred to as a melanoma) has nothing to do with advancing the disease or making it worse or triggering a "silent" cancer. Removing the melanoma was the right thing to do. There was no way of telling that it had advanced as far as it did. But removing it did not cause the spread of the cancer. Had he left it alone, he would have still had the same results.

What is important is that you now have skin surveys to guard against the possibility that you are vulnerable to developing one since it can be a genetic mutation that causes it.

I'd also like to stress that I too was told "it doesn't look like anything" by my primary physician about eight months before I had a dermatologist look at it. He took one look and said 'let's get a biopsy.' If you feel that you have something out of the ordinary, insist on a biopsy to ease your mind. The fact that your brother passed away from a melanoma should be told to the doctor you see. That should be enough evidence that you require a biopsy.

My mother died of squamous cell cancer of her ear canal that spread like your brothers. My brother has had a small squamous cell cancer removed from his scalp. I neglected to tell my primary physician about my mother; my brother told his doctor straight away and the doctor didn't hesitate biopsying the area. And when I saw the dermatologist, I then told him about my mother and brother and he didn't hesitate to remove it for biopsy.

I have had some very patchy scaly spots on my face and a lot of redness that has appeared. Now I will be treated for that. I always thought that when I saw my primary physician that she would see those patches and redness and tell me if there was something to worry about. I have learned that I need to speak up and be an advocate for myself. Please now make it a habit of getting your skin checked once or twice a year. I hope this helps.
 
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Elizabeth_WebMD_Staff replied to rebecca3380's response:
Hello and Welcome Rebecca,

I am so sorry to hear about your brother. It is frustrating and difficult to understand how and why this happens so suddenly.

In addition to the information that millicentbash provided, I encourage you to begin a new discussion for possible response from other members and experts. To do this go to the top of the page and click on the orange Post Now button and choose discussion.

You have a very good question that could benefit others and don't want it to get lost in this discussion.

Elizabeth


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