The verdict is in.....Derm it is!!!

So I finally decided, sometime last week, I think, to do derm! I feel very relieved to have finally decided on something, and this time I can't change my mind, because I'm literally out of time to - it's great! So right now I'm sitting at Panera, working (sort of...) on my personal statements - lots of fun....In my endless efforts to procrastinate I thought I'd show yall what I'll be working on in the future. If you ever wanted to know what your skin looked like close up, here it is:

So for the next few months I'll be checking my email/voicemail an absurd number of times because that's how they contact you to let you know you have an interview. At best, any given med student only has about a 60% chance of matching in dermatology, mostly because there are so few spots. They've kept the number of dermatology residency spots artificially low, because that increases demand, and therefore pay....So if you ever wondered why it takes 4 months to get into see the dermatologist, that's why! So since I'm a D.O. applying to only M.D. programs my chances are probably less than that 60%, but I'll try to keep positive over the next few months....Most types of programs interview from October through December, but derm, because they're so special, makes everyone wait and they don't interview people until December through February....nice....

So here is one of the things I'll be treating...Below is a something called a squamous cell cancer of the lip. For whatever reason if it's on the lips, it shows up on the lower lip 90% of the time...This one would be very tricky to remove, because it's huge, and if you mess up, the person may be drooling/not able to smile right for the rest of their life. They have a sort of new surgical technique that does a really good job with lesions on the face especially. It's called Mohs micrographic surgery, and when they remove a lesion, they literally graph out where it was, and look at it under a microscope. They can tell immediately if any malignant cells were left, and then they know exactly where they came from. It has a much better cure rate than conventional surgery, and the patients have a better cosmetic result.

The next picture is a basal cell cancer. The difference between the basal cell and the squamous cell cancers is basically the cell type, and the fact that squamous cell cancers are more invasive and metastasize (spread to other organs) more often (even though it's still pretty rare). The way you tell it's a basal cell cancer is that it's kind of pearly-looking, with a rolled border and it usually has teeny blood vessels running through it.

This is how a squamous cell cancer would look if you were looking at it under the microscope....Everybody remember the lovely keratin pearls we all had to memorize for histo? That nice pink ball in the middle/right of the field is called a keratin pearl, and they're found in any kind of squamous cell cancer, be it in the skin, the lung, or wherever....If you see one on a slide it's not a good thing...