Wednesday, February 21, 2007

The Case of the Maltese Cur















A 69-year-old woman presented with a six-month history of a lesion on the bulb of the nose. This began after her Maltese dog scratched her on the nose and the area has never healed. She used mupirocin ointment without relief, in addition.

EXAMINATION: The examination shows a light-complected Caucasian. She has an irregular 1 cm in diameter crusted area on the bulb of the nose.

Pathology: A shave biopsy was taken for diagnostic purposes. This showed an infiltrating BCC. The photomicrographs were taken by Dr. Jag Bhawan, SkinPath at Boston University School of medicine.




4x













10x








20x








Plan: I will recommend micrographic surgery.

Question: I hear this story frequently. My cat, dog, grandkid scratched me on my nose, cheek, etc. and it didn't heal properly. I assume it's just chance -- but what do you think. Should she put the dog down? What would PETA say?
at

4 comments:

  1. Dr Ian McCollFebruary 22, 2007

    Bcc arising after injury to the skin has been reported in the past but the phenomenon is much commoner with keratoacanthomas particularly after freezing solar keratoses. Obviously patients do like to rationalise things appearing on the skin but I think the preceding injury phenomenon is correct.

    ReplyDelete
  2. AnonymousFebruary 22, 2007

    If you ever watch daytime TV (which I'm doing far too much of) at least once a month someone is doing a show on "how my pet saved my life...." Dogs detecting occult tumors seem to be almost common by "daytime" standards . They use dogs to sniff urine and detect bladder cancer...the last study I saw the dogs did better than any chemical marker. Maybe the dog scratched her... because her nose smelled "tumor funky"
    Just a thought

    ReplyDelete
  3. AnonymousFebruary 23, 2007

    We should remember the fact that tissue of BBC is very fragile that could be easly damaged by any simple trauma like finger scratch or playing with dogs otherwise all other thoughts are illuusions
    khalifa sharquie

    ReplyDelete
  4. AnonymousMarch 01, 2007

    I agree with the comments made. In particular, there is some suggestion that tumors or other medical problems may give off an odor of sorts that only animals can sense, and at the same time, patients love to associate things, and likely the nose was fragile with the BCC, and a little pawing uncovered the lesion. Another life (or nose) saved by a dog!
    Ben Barankin

    ReplyDelete

We welcome your comments. We endeavor to serve your patients and you. If you want us to respond, please add your name and email address. Some people have trouble uploading comments. In that case, please send comments directly to djelpern@gmail.com. Thank you.