Category Archives: doctor

The Blue Nevus

When I saw my primary care physician back in November, she asked me how long I had had that discoloration on my scalp.
I said, “What are you talking about?”
Indeed, there was something there, though neither my wife or I had noticed it. My doctor wanted me to see a dermatologist. Naturally, that takes awhile.
So it was only 10 days ago when I went to the dermatologist, who said, “Ah, you have a blue nevus.”
Now does that not sound like a car or a flower or perhaps something in space?
No, the blue nevus is a variant of a common mole. It is composed of melanocytes, the cells which produce the melanin pigment, which have a spindled to epithelioid appearance. This nevus gets its name from the distinct clinical appearance because of the pigmented cells within the dermis.

So what should I do about it? I noted that my doctor saw it in November but had not seen it in my ptrevious annual visit. Its recent appearance was an issue for my dermatologist; if I had had it for 20 years, he wouldn’t have thought much about it. This not being the case, he said he thought we should have it removed.
I said when should we do that?
He said, “Now, if you’re up for it.”
He numbed the surface with a topical liquid, then gave me a shot (which didn’t hurt), then removed the nevus, needeing three stitches to patch me up. It was a bit more bloody gauze than I would have expected from such a little mole.

I was to come back this past Thursday to remove the stitches and to get the results of the biopsy. I wasn’t worried, since these are almost always benign. On the other hand, in the United States, Blue nevi are most frequently noted in Asian populations, where the prevalence is estimated to be 3-5% in adults. They are found in 1-2% of white adults and are rarely found in blacks.

So I’m atypical. “Blue nevi are twice as common in women than in men.” Also, “Rare cases of malignant melanoma have been reported arising in association with cellular blue nevi.”

I return to the dermatologist as scheduled, got the stitches out and good news about the nevus. The one down side is that it was deep, and it might come back someday, so I may undergo this procedure in the future.


The Lydster, Part 41: A Pain in the Butt

A couple days before we went on our trip to the Berkshires in June, Lydia somehow got a thorn or something similar through her bathing suit into her posterior. She didn’t tell the people she was with at the time, but only complained later. Carol and I couldn’t get it out, so Carol called our pediatrician.

Carol claims, and I believe her, that she heard tones of snickering and even mild mocking in the response by the receptionist when she made the appointment on the Friday before the trip. You mean these pathetic parental units couldn’t get a little sliver out of their child? I think we took some mild emotional satisfaction, mixed with medical concern, when Lydia’s doctor couldn’t get it out, either. He recommended heat and other salves to try to draw out the foreign object. If it’s not out by the end of the weekend, he recommend that Lydia see a surgeon. A surgeon for a sliver!

Well, we left for the Berkshires on Sunday, but first thing Monday morning, Carol called the surgeon’s office, and made an appointment for the next morning. We drove back to Albany on what may have been the hottest day of the year; I remember distinctly leaving a fitted sheet over Lydia’s car seat, so that the seat and the metal wouldn’t be too hot when we return.

Carol, the nurse and Lydia were in the room when I heard Lydia screaming. I assumed this was the shot to numb the area. No, it was the numbing cream used in anticipation of the shot. The actual shot went relatively easily.

The surgeon was called away on an emergency for a time. Finally, when the actual removal took place, it involved the surgeon removing the object, and the nurse and two parents holding the child.

We had lunch and soft ice cream after that, then returned to our vacation locale.

(This will be one of those posts where, years from now, she will undoubtedly chastise me.)

These are her favorite colors.