Hi,

I had a squamous cell carcinoma on my shin (about size of pencil eraser on surface) removed 1 1/2 months ago.  The doctor used Mohs method.  He only took one section and said he thought he had it all.  The initial biopsy pathology report said it was highly differentiated, which he said was good, but I told him that it had come up and grew quickly and was painful (from the time I first noticed it, it grew 4 times in width and raised up quite a bit within 1-2 months) and I was worried that it seemed to be aggressive in it's growth. 

He had me wait a week before doing reconstructive surgery - the area that he removed was about the size of a nickel or quarter and maybe 3/16 to 1/4 inch deep.  He did a skin graft from under my arm a week after the original surgery.  The graft looked to me like it was not taking, although he said that it looked good - it had turned dark red on top and some skin was shluffing off.  It still looks like a mound with a crater about the size of a dime in the middle.  I have worked with it meticulously over the past 5 weeks and was concerned about infection during the last 2 weeks.  I saw him and he gave me a prescription for sulfa antibiotics and altrabax ointment (I use both twice a day).  He said to keep it covered and moist - do not let scab form.

Here's the problem - the area around the excision has steadily turned red, expanded in diameter and swelled in height around the perimeter of the original excision and graft.  It feels hard and is very painful to the touch around the perimeter and out into an area about the size of a silver dollar now.  Everyplace that feels hard under the skin is painful to the touch.  To me it kind of looks kind of cancerous itself.  Am I being too nervous?  I'm worried that he didn't get all of the cancer and that it has spread out much larger and deeper than before.  If not that, I am wondering if I have a serious infection that needs more attention.

I'm thinking that I may need to get a second opinion.  What do you think?

Thanks