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Dr. Nair
Dr. Nair, Dermatologist
Category: Dermatology
Satisfied Customers: 9182
Experience:  MBBS, MD (Dermatology, Venereology & Leprology)
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I am having an ED&C on Monday next week for a Basal Cell. I

Customer Question

I am having an ED&C on Monday next week for a Basal Cell. I am wandering after the numbing meds wear off if I will feel a lot of pain from this procedure. I have had a rough week having a slight concussion from hitting my head and a painful knee. Just wandering what to expect. Also is it okay to do this procedure when I am healing from a concussion?
Submitted: 6 months ago.
Category: Dermatology
Expert:  Dr. Nair replied 6 months ago.

Hello,

Thank you for your question. My name is***** - I am a Dermatologist and will do my best to provide a useful input.

How big is the Basal Cell Carcinoma and where is it located?

Customer: replied 6 months ago.
The basal cell was superficial and very very tiny, almost looked like a tiny skin tag. The biopsy report said it was all clear around the edges. Not sure why I still have to do this. I think the biopsy got it all.
Expert:  Dr. Nair replied 6 months ago.

In that case you have nothing to worry about, the doctor is being cautious which is always a good thing. You will have a little discomfort 4-6 hours after the procedure but this usually wears off over 24-48 hours and a painkiller like Advil 400 mg can be taken if required. And recovering from a concussion is not a problem as far as the planned procedure goes.

Please feel free to ask if you have any queries.

Customer: replied 6 months ago.
Will the discomfort be similar to a biopsy or a little more?
Expert:  Dr. Nair replied 6 months ago.

Very similar to a biopsy

Customer: replied 6 months ago.
ok. I just thought it may be more painful since they were going deeper and burning?
Expert:  Dr. Nair replied 6 months ago.

Not really the burning is quite superficial (till the papillary dermis) and the pain after is very similar to what you feel after a biopsy since the same group of nerves are involved.

Expert:  Dr. Nair replied 6 months ago.

I'd be happy to answer further queries if you have any. If not kindly consider rating our interaction positively to enable me to get credit for my work with you. You can continue to follow up even after if required. Thank you.

Customer: replied 6 months ago.
I have another question not related. I had another dr.try to answer who wasn't a dermatologist. It would be great to have your expert insight.
Customer: replied 6 months ago.
Since the biopsy report shows edges are clear, does that mean it is likely that it was all removed during the biopsy or is this something that can be deeper? Why can I just wait and see if it returns? If it returns does it return in a different way than it was originally like more aggressive? They tell me it isn't a good idea to wait. I would think it would just pop back up and then I could have it removed. My second question is on a different topic: I have had 2 small rashy areas on right and left foot. One of them I am pretty certain is fungal, due to the fact I had something that looked similar about a year ago and was diagnosed as fungal. This one also itches. The other is on my right foot and looks different and doesn't itch. I am attaching 2 pics and just wanting to know if they look the same to you or different?
Expert:  Dr. Nair replied 6 months ago.

Good Morning,

Each physician treats BCC a little differently - waiting and watching is definitely an option if the biopsy margins are clear and the intention was to remove the entire lesion during biopsy and not just take a piece from the edge.

Your foot rash looks like Discoid Eczema. This needs treatment with prescription strength steroid creams.

Customer: replied 6 months ago.
Hi Dr. Nair I am attaching my biopsy report to see if you think the ED&C is something I can hold off on. My dermatologist doesn't think it is a good idea. Also those pics I sent you of the foot rashes. Do both look the same? I had something similar a year ago and the scraping came back as fungal. I have been using Econizale Nitrite Crème on both of the areas for a few weeks now. Will that hurt anything if it isn't fungal?
Expert:  Dr. Nair replied 6 months ago.

This report is just the gross description, does not include the biopsy report. I see though that this was a shave biopsy which is why your doctor wants to go in and clean up the remaining area. I would support this line of approach even if the margins were clear on biopsy - there can be skip areas on a shave biopsy since very little dermis is included and sometimes BCC nests are found a bit removed from the epidermis (superficial layer of skin) and may be missed on a shave biopsy.

No Econazole will not hurt matters if this is not fungal.

Customer: replied 6 months ago.
the document I sent has Diagnosis in Part A at top of page
Expert:  Dr. Nair replied 6 months ago.

Good Morning,

Right I see it - normally the histopathology report is much more descriptive than that. Anyways it says the margins are narrowly free and given the fact it was a shave biopsy and not an excision biopsy, I strongly second the ED&C procedure.

Kindly consider rating our interaction positively to enable me to get credit for my work with you. You can continue to follow up even after if required. Thank you.

Customer: replied 6 months ago.
What does narrowingly free mean

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