Skin biopsy

[Pippa63]

I have a patch of skin which needs removing for biopsy from my cheek on my face I told the doctor about my condition but she didn't suggest I do anything prior to this. It will be done with local anaesthetic at the day surgery. However . I saw my heamo today which is at a different hospital and she seemed a little concerned about bleeding and asked if I had told them of my condition which I had. She said stop the aspirin 7 days before ......I'm wondering if I should inform the other hospital of this before I go next week to get it done......my question is has anyone had skin lesions or melanomas removed and what was the advice? Thankyou

[Rachelthepotter]

Yes: I’ve had skin lesions removed, and I’m taking rivaroxaban, which is quite a strong anticoagulant. The very clear advice from both the haematologist, and dermatologist 1 , was don’t stop taking the anticoagulant, as the risk of clotting is far more serious for me than the risk of bleeding a bit.

Hope this helps.

[Pippa63 in reply to Rachelthepotter]

Thankyou for your input

[piggie50]

Hi Pippa,

I had a SCC removed from my hand, the wound was about 2 inches in length. I take Hydroxicarbamide and 75mg aspirin. I did not need to stop the meds. They packed my hand with a big dressing and it was fine.

Good luck

Judy

[Pippa63 in reply to piggie50]

Thankyou that's reassuring

[Cyclemore]

Hi. Similar to the other respondents, I have had 2 BCC removed from my chest and another arranged for January. Not advised to change from the Hydroxy or aspirin I take. Increased skin lesions is my primary symptom.

[Pippa63 in reply to Cyclemore]

Thankyou hope all goes well in January

[Jazzyb50]

Hi, I've had melanoma and two BCC's removed prior to and also whilst taking Hydroxycarbamide and aspirin. I wasn't advised to stop meds for removals.

[Pippa63 in reply to Jazzyb50]

Thankyou. It seems most still take the aspirin

[Bobthecob]

Hi Pippa, I have had a BCC removed from my nose, it was done in hospital mainly I was told because of the bleeding and infection. I have since had two further skin biopsies on my face, it did bleed a lot but I informed the hospital about my medication. I take Hydroxycarbamide and Clopidogrel they were not stopped prior to the procedure. I think it would be wise to inform the hospital. Hope this helps.

[Pippa63 in reply to Bobthecob]

Thanks. I have informed hospital and the maxillo facial admissions say they don't ask anyone to stop their medications . I said what about aspirin? And was told to take it

[socrates_8]

Hey Pippa...

Sorry to hear about your skin problem... All these things can make us all a tad over anxious at times...

However, I believe that you are absolutely right and the doctor performing the biopsy should ABSOLUTELY be first talking with your Haematologist, in my view...

If it was me, I would be demanding their co-communication... Holistic approaches are required, in my view...

I have not had such a procedure myself, as yet...

However, there is a guy that I know who has. His name is Warwick, and you can find him on the Australian MATES MPN Forum website:

mpn-mate.com/forum/viewtopi...

This is a Post that Warwick has contributed too...

I am sure he would be happy to tell you of his 50+ skin cancers that he has thus far had to remove etc...

Best wishes

Steve

(Sydney)

[Pippa63 in reply to socrates_8]

Thankyou so much your always so informative and helpful on this forum

[Chemo01]

Hi I have ET and am on Hydroxy and aspirin. A year ago I had quite a large squamous cell lesion removed from my right cheek it was about 2cm across and growing fast, I was told to stop aspirin for a week before the operation and for a week afterwards, this was mainly because of the likely hood of needing a skin graft and grafts don’t take well when your on aspirin. As it turned out the surgeon managed without having to use a graft. Then shortly after I had to have a Basal cell lesion removed next to my nose on the same side of my face, this was a lot smaller and I was told that I could keep taking aspirin so I think yes you bleed more but if the surgery is quite large and involves a graft then aspirin would have to be stopped, take advise from the surgeon and your heamo about what’s needed hope all goes well x

[Pippa63 in reply to Chemo01]

Thankyou mine is being done at the hospital with a local anaesthetic so don't forsee anything major ...hope all is well for you now

[hunter5582]

I have had multiple surgeries while on aspirin and HU. The docs typically had me stop the aspirin 3 - 7 days before surgery along with any other blood-thinning agents. Also discontinue for at least several days after the surgery. Always stayed on the HU throughout the process.

It is VERY important for the dermatologist to consult with the hematologist about your care. Any time you experience significant bleeding, inflammation or tissue damage it can trigger reactive thrombocytosis, which is the body's natural response to trauma. Not sure if you are on hydroxyurea, but if you are then certainly the hematologist needs to be in the loop as HU can cause skin cancers.

Do be sure to insist on the docs consulting with each other. Assertive patients receive higher quality care. Passive patients do not.

[Pippa63 in reply to hunter5582]

Thankyou. Yes I'm on hydroxy for ET as well as other meds. When I showed my heamotologist the skin problem she said oh what's that! I will ask again about the aspirin .

[hunter5582 in reply to Pippa63]

Sigh! One would hope that when hematologists prescribe meds that are known to cause skin cancer they wiuld be more familiar with those manifestations. Does demonstrate why it is so important for patients to insist on close collaboration between providers. Hope you get this straightened out ASAP

[beetle]

I had skin biopsy with a platelet count of 40. They kept me for and extra 15 mins to make sure I didn’t bleed excessively and they were very thorough with the dressings. All was well. Hope yours goes well too

[Pippa63 in reply to beetle]

Thankyou

[wormwood]

Hi... I had the same procedure done, and there was very little bleeding... it literally took seconds .... I bleed very readily... and there wasn't s problem...

[Pippa63 in reply to wormwood]

Thankyou. Glad it went well for you

[Lemonverbena]

hi pippa i have had bcc removed and am on hu and warfarin. the initial removal done with local anaes that also have adrenaline in which reduces blood flow to area. later bigger incision under full anaesthetic and a protocol with stopping blood thinning prior to op, post op injections/ inr checks that was consulted with haem team so think if local anaes should be fine.

i would however write a short note to both teams informing them of meds and procedure and include each others tel no. no harm in double checking.

good luck!

[Pippa63 in reply to Lemonverbena]

Thank you for your reply and advice