Dr. Pimple Popper Spots Cancer on Man She Was Treating for Enlarged Nose Basal Cell Carcinoma Hiding in Plain Sight

David first met Dr. Lee when he was assigned to be her limo driver. But during their drive, Dr. Lee said she was “stopped in her tracks” by David’s enlarged nose.

“I feel like this was sort of meant to be. What are the chances that he was driving a car that i was in and that we met in this strange way and now he’s at my office?” Dr. Lee said in the 2020 episode.

Dr. Lee invited him to her office to treat a severe case of rhinophyma, which is a skin disorder that causes the nose to become enlarged. And it was during this visit that she was able to notice a lump of discolored skin underneath David’s right eye. She quickly suspected it was a form of skin cancer.

"I did notice a very suspicious growth underneath his right eye I think it could be skin cancer. I didn't want to alarm him while we were doing the nose surgery, but I did take a biopsy and he's back here for us to discuss the results," Dr. Lee explained on the show.

The biopsy revealed David had basal cell carcinoma, a common and curable – but still serious – form of skin cancer. This took his daughter Richele by surprise.

"I know the 'C' word is a scary word, but the best course of action is to remove it when it is as small as possible," Dr. Lee explained to David and his daughter as they processed the cancer diagnosis.

Coping With a Diagnosis

A cancer diagnosis can be shocking and intimidating, along with a slew of other emotions. Experts recommend not blaming yourself for the disease. One helpful suggestion for cancer warriors at the start of their cancer journeys, is to learn more about the disease. Also asking your doctor additional questions and even seeking a second opinion can help ease the initial shock and anxiety associated with a new diagnosis.

What to Know About Basal Cell Carcinoma

Basal cell carcinoma (BCC) is the most common form of skin cancer with an estimated 3.6 million cases diagnosed each year in the U.S., according to the Skin Cancer Foundation.

BCC is a type of highly curable skin cancer that causes a "lump, bump, or lesion to form on the outside layer of your skin," where there is a lot of sun exposure, according to the Cleveland Clinic. The lesion can look like a "small, sometimes shiny bump or scaly flat patch on your skin that slowly grows over time." These bumps can often be overlooked as a pimple or skin tag. In patients with darker skin, about half of BCCs are pigmented (meaning they are brown in color).

The most common type of BCC is a nodular BCC, which looks like "a round pimple with visible blood vessels surrounding it." Other signs of BCC include:

• A lump that is slightly see-through and close to your normal skin color
• A lump that may be itchy or painful
• A lump that may form an open sore, which can ooze clear fluid or bleed with contact

If you have a spot on your skin that seems abnormal or questionable, you should consult your doctor because BCC can look very different from person to person. In addition, you should prioritize routine checkups with your dermatologist and always be on the lookout for any skin changes in between visits.

A doctor may diagnose BCC through a skin biopsy, which is when a piece of the affected skin area is removed to examine under a microscope. They may also use imaging tests if they suspect the cancer has spread to another area of the body, though that is rare for BCC.

While BCC lumps are slow-growing, they are still serious. If left untreated, they can grow in size and begin to invade deeper layers of the skin and tissues, like muscle and bone. Plus, BCC lumps can be painful and become ulcerated (become an open sore), which can cause bleeding and infection.

Dr. Lee also said David's BCC could have caused him major problems if left untreated.

"If you let it grow to a large size it could impinge on part of the eye and take over the nose…it's something you need to remove," Dr. Lee said.

Basal Cell Carcinoma Treatment Options

There are a few ways BCC may be removed from the body, according to the Cleveland Clinic, and they include:

• Scraping off the cancerous lump and then burning the layer of skin with an electric needle
• Surgically removing the lump with a scalpel (Mohs surgery)
• Freezing the lump
• Chemotherapy (using medicine to kill the cancerous cells)
• Laser therapy (using high-energy laser beams to remove the cancer)

Dr. Lee opted for Mohs surgery to removed David's BCC.

WATCH: Mohs Surgery Removes Skin Cancer With Smaller Incisions.

"Mohs microscopic skin cancer surgery… so what I'm going to do is take off what I see there and about a millimeter of normal tissue around it," Dr. Lee described.

While performing the procedure, Dr. Lee examined David's tissue underneath a microscope for signs of cancer cells and after two rounds of removing tissues associated with the basal cell carcinoma, Dr. Lee declared all the cancer cells were removed.

"You're able to remove a very conservative margin around the cancer and study it in essentially real-time," explains Dr. Sumaira Aasi, Professor of Dermatology and Director of Mohs and Dermatologic Surgery at Stanford. If, when the surgeon examines the tissue under the microscope, cancer is found, the surgeon goes back and removes some more tissue bit by bit.

The idea is that by making the tiniest cuts and evaluating them microscopically, the surgeon knows for certain that all the cancer is out when the last piece of tissue proves to be clear. It is often done as an outpatient procedure with local anesthetic.

"When they took it off, it was about the size of a nickel…it's kind of unnerving…He's out of the woods, he's cancer free," Richele said about her father's prognosis.

Dr. Lee told David he's "all clear" as he left the operating room to continue recovering at home. Roughly six weeks after the surgery to remove the BCC, David said he felt so much better.

"Everything's gotten better. I look normal" he said to laughter.

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