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Sunday, July 21, 2019

My SKIN CANCER at 48: I Have A BASAL CELL CARCINOMA #SkinCancer #BasalCellCarcinoma #BCC

lesion before biopsy was taken: a confirmed basal cell carcinoma
In my life I have accrued a lot of sun damage. I'm not going to lie about it and act like I didn't go out in the sun a lot when I was little. My mom and grandmother took me to Nags Head Beach on the Outer Banks, NC when I was 5 and I got sun poisoning. I remember being very sick and having the worst sunburn. The sunburn blistered and I had a fever, vomiting and a very bad headache. And a lot of itching. 

Then when I was older I would go swimming and not reapply, although I would always start out with sunscreen. At least my mother or grandmother meant well. They knew me. They knew with my blonde hair, very fair complexion and blue-green eyes that I couldn't go into the sun at all. After all, my genetics was believed to be all German and some British and Scottish at that point. With my very fair complexion, blonde hair and blue-green eyes, I'm a Fitzpatrick I on the sunburn and skin cancer risk scale. That means I have the most risk for skin cancer. 

I continued to stay out of the sun in my teens and had a couple of bad burns in my early 20's when I was in Greece with my Greek husband, who has enough melanin in his skin that he turns black in one day of being out in the sun, whereas I turn into a lobster after 15 minutes of being out in the sun. So in Greece they use yogurt as a method to help soothe and heal the skin (more later). That was the last time I ever burned in the sun because ever since, I never stay out in it and I always wear a SPF30 of higher when I am in Greece or anywhere like Florida, Myrtle Beach or the Dominican Republic. And I make sure to reapply.

However that didn't seem to stop the damage that had already accrued in my skin, which took what looked like a regular mole and changed it into what I thought was a squamous cell carcinoma (and what the dermatologic nurse practitioner thought was a hemangioma or blood tumor) into their office the very next day after I noticed it. I was lucky to get in the next day I thought. I didn't think it looked like a basal cell carcinoma or a melanoma at all. When I went in, he said it looked like a hemangioma, because it looked like it had stalks to it. But two days ago I got a call saying that the lesion was a basal cell carcinoma and that I have to go back in, get the rest of the margins excised and get some stitches. Just look at the photo, you can see the lesion amongst the keratosis pilaris on my arm. 

Here is a photo of it after they left the scab from taking a biopsy:

excision after biopsy was taken

Here is a larger view of my lesion, along with my keratosis pilaris (lol):

lesion before biopsy was taken: a confirmed basal cell carcinoma

Here is a view of my stitches and my scar:

above: stitches after tumor was excised

above: scar after stitches came out.

I know it's kind of hard to see the lesion. I'm going to see if I can get the photos that the dermatologist's office took. The lesion was close to my shoulder and even with steadying my camera it looked blurry. As you can see the lesion is red, irregular, it bleeds and it is slightly painful (which the nurse told me is usually good). It used to be a mole. Then all of a sudden it turned into that very suddenly and one day I woke up and saw the lesion there. It couldn't have been more than a couple of months because I looked at my arms all winter and didn't notice anything different. Even after getting most of it out now, it still hurts when I press on it. 

That is where they have to get the rest of the margin out I suppose. I did find out that it was called a granular basal cell carcinoma. There are three kinds of basal cell carcinomas and that it the kind I had. Mine seemed to be in Stage II. The scar will lighten up over time and I am not really worried about it. It is kind of my badge of honor now. Besides the scar will not turn out that bad. MOHS surgery is much worse. When they went back in for more of the tumor it was easy for him to see where it was and where it was needed to be cut out. The biopsy came back clean. 

Your risk for skin cancer is at the heart of the Fitzpatrick scale: This scale was designed by by John D’Orazio, Stuart Jarrett, Alexandra Amaro-Ortiz and Timothy Scott. 

Here you can see the palest of the pale have the highest skin cancer risk because they have very little melanin in their skin and they burn and do not tan, you can also take into account eye color. 

  • Type I (scores 0–6) always burns, never tans (palest; freckles).
  • Type II (scores 7–13) usually burns, tans minimally
  • Type III (scores 14–20) sometimes mild burn, tans uniformly
  • Type IV (scores 21–27) burns minimally, always tans well (moderate brown)
  • Type V (scores 28–34) very rarely burns, tans very easily (dark brown)
  • Type VI (scores 35–36) never burns (deeply pigmented dark brown to darkest brown)

The Fitzpatrick classification schema for human skin color was developed in 1975 by Thomas B. Fitzpatrick as a way to estimate the response of different types of skin to ultraviolet (UV) light. It was initially developed on the basis of skin color to measure the correct dose of UVA for PUVA therapy, and when the initial testing based only on hair and eye colour resulted in too high UVA doses for some, it was altered to be based on the patient's reports of how their skin responds to the sun; it was also extended to a wider range of skin types. The Fitzpatrick scale remains a recognized tool for dermatological research into human skin pigmentation.

I am always a Fitzpatrick I on the scale and my risk for skin cancer is very high. I have known this since I started studying skin in my teenage years. I have tried to avoid the sun and used sunscreen as much as I can but I know that my time in Greece didn't prepare me for the Mediterranean sun. My ex-husband is a VI on the scale and luckily our daughters are a Type III or Type IV. Depends on the daughter. 

I did my Ancestry DNA. Turns out I am much more fair-skinned than I thought. I am only 30% Germanic Europe, 57% England, Wales and Northwestern Europe, 5% Ireland and Scotland, and 5% Swedish 3% Norwegian. I don't even know where the Swedish and Norwegian came from. But all of this does explain why I am so fair and it explains why I don't tan at all. I am of mostly Northern European extraction. The German in me explains why I am 6'1" and that could also be explained by the Swedish and Norwegian but the paleness of skin could be explained by every darn genetic extraction I have. 

If I get a bad sunburn what should I do to heal it? Well there are a couple of things you can do for it. Take an anti-inflammatory med like a NSAID (aspirin, ibuprofen). That will help with the pain and inflammation. It should help take down some of the redness too. If you have it aloe vera juice soaked cloths would be good to lay on the sunburn. Those will help soothe the sunburn and ease the peeling, the redness, etc. If you don't have aloe vera, get your hands on some regular Greek yogurt. Spread it on the burn. It will help soothe and ease the pain with the lactic acid in the yogurt. Greek is good because it is thicker and more potent. 


Until Then~

Marie Papachatzis
Follow Me On Instagram:iamthemakeupjunkie

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