T had a bump on her arm. We tried treating it with Compound W thinking it was a wart. After a couple days with the Compound W it started bleeding so we made an appointment with a dermatologist. He looked at it said it might be a wart but it kinda didn't look like one but maybe it was it didn't really look like a melanoma but.... First he decided to send us home to try Compound W for a couple more weeks. Then he came back while we were making a follow up appointment and said he wanted one of his fellow derm.s to take a look. He looked said it really didn't look like a wart but maybe it was. They eventually decided to go ahead and do a 4 mm punch biopsy.
The biopsy came back as an atypical Spitz nevus. More here http://emedicine.medscape.com/article/1059623-overview
The recommendation was to excise a 1 cm margin around the site. Because of the size of the excision and the way it would need to be repaired T would end up with a 6 cm incision on her left forearm and it would have to be done under general anesthesia. Today we saw a general surgeon at the Naval Hospital. He recommended that due to the size of the incision and the amount of tissue that would need to be removed that we see a dermatologist out in town who can do a Mohs procedure. With this procedure instead of taking a 1 cm margin they take a 1 mm margin and map any abnormal cells. If they find any they can they target the area with the abnormal cells and do further excision. This procedure will (hopefully) minimize the amount of tissue they will have to excise and leave her with a smaller incision.
More on Mohs http://en.wikipedia.org/wiki/Mohs_surgery
Even though Mohs is most often used to treat skin cancer T does not have cancer. In all the studies that have been done on Spitz Nevi there are no documented cases of any type of metastasis.
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