Growth on nose

[Leo71]

My husband is being treated with acalabrutinib for CLL , taking it for about 7 months. His white blood cell count was raised significantly at first but after 5 months it started to come down slowly and his lymphocyte count is now 150. About 3 months ago he started to have two black/bloody growths on his nose, about the size of a wart. Initially they would grow, break off and re-grow. One has now healed altogether but the other has got bigger over the last couple of months, is quite raised and bleeds if knocked. He has sent photos to his GP but has to wait a couple of weeks for an appointment. Has anyone else experienced this sort of problem?

[Snakejaw]

I don’t know how helpful my testimony would be as I was not on treatment when I had a growth on my nostril. It would grow and then crack/bleed, then heal and repeat the cycle. I had it removed and biopsied, and it was benign. I have many atypical moles and related things on me, so I’m used to having things checked. I’ve even had photos taken to help monitor them, and I go in annually for a check in with my dermatologist. I would have it checked out, but as someone who has a lot of skin issues, I try not to lose sleep over them.

[lankisterguy Volunteer]

Hi Leo71,

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You have likely read on this site that we CLL patients have skin cancers 5X to 8X more often than folks with normal immune systems. And as I have read* 25% of CLL patients get other skin issues like Seborrheic Keratosis, Plaque Psoriasis, etc. which are non-cancerous lesions (growths), but after 14 years of CLL and many skin artifacts, I cannot tell the difference, but my dermatologist can.

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I have read that several UK NHS patients must wait many months to see a dermatologist, so you may need to be persistent getting the attention of his GP to get a response and referral.

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*The NIH has several papers suggesting that CLL itself leads to skin issues, as noted here:

ncbi.nlm.nih.gov/pubmed/174...

SNIP: "Cutaneous lesions occur in up to 25% of patients with chronic lymphocytic leukemia (CLL). These can be caused by either cutaneous seeding by leukemic cells (leukemia cutis, LC) and other malignant diseases or nonmalignant disorders. Skin infiltration with B-lymphocyte CLL manifests as solitary, grouped, or generalized papules, plaques, nodules, or large tumors.....The most common secondary cutaneous changes seen in CLL are those of infectious or hemorrhagic origin. Other secondary lesions present as vasculitis, purpura, generalized pruritus, exfoliative erythroderma, and paraneoplastic pemphigus. An exaggerated reaction to an insect bite and insect bite-like reactions have been also observed".

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Len

[Leo71 in reply to lankisterguy]

Hello Len

Thank you for that. I'll look for pictures of those different conditions and see if any of them match my husband's problem. The mention of insect bites was interesting as he had a facial swelling some time ago and it was thought that was a spider bite. Fortunately one of the GP's at our practice is a specialist dermatologist and will perform minor surgery on skin lesions if necessary.

Sylvia

[lankisterguy Volunteer]

Hello Sylvia/Leo71,

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I was trying to convey that matching appearances to photos on the internet has NOT worked for me or my wife trying to examine my skin.

My dermatologist uses a special polarized light & filter to sort out which are cancer and which are benign.

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Len

[AussieNeil Administrator in reply to lankisterguy]

To which I'd add that when you see the photos that dermatologists take of spots of concern using their specialised imaging capability optical viewers and apps, there is so much more information captured about shape and what is going on just under the skin, that seeing anyone who makes a call base on a standard visual inspection with magnification is just too risky.

[carnvellan]

Having had a lot of attention from my hospital dermatology department, sometimes on spots I took no notice of, I can't stress too strongly that you should get your GP specialist to examine you regularly - certainly annually. I have found that my NHS GP and hospital are quite happy to do this and will see me urgently if I ask for it.

[Billhere]

Dermatologist visits should be every 6 months and whenever any unusual skin events occur. GP’s are never a wasted visit but cannot substitute for dermatologist.

Melanoma can progress to a metastasize stage in as little as 6 months.

Most skin oddities are benign but take no chances!!!

I have found dermatologists to be very inexpensive and easy to access but thats here in the US.

[Vlaminck]

Just thought I'd throw out that the only skin thing I've had that can sort of "break off"and grow back is a wart above my knee. It can be scraped off but it's still there to grow back (less than pencil eraser size). Just a possibility? Warts of course are caused by viruses.

[Mijoed]

Yes, I had something similar. It turned out to be a bcc that was easily removed under a local anaesthetic.

[LeoPa]

I'd get it cut out first and ask questions later.