To think this could be very serious?

[RichPetunia]

This growth has appeared on the side of my mum’s face, very suddenly. The doctor thinks it’s shingles. I think it’s not and could be something more sinister. Any opinions please?

Wow this doesn’t look like shingles! Best of luck with your second opinion!

I’ve had to demand a referral from my GP regarding a lump I’ve got on my neck. They ran bloods (inconclusive) and bloods don’t show a lot the HP even said this they show inflammation but that’s par for the course due to my health condition. I’ve lost sleep so much worrying about this and I know how fast things can change with lumps. Finally a GP has referred me for a scan on it. IMO if it’s new and it’s worrying you get it checked out and if you’re not happy with a GP’s response you’re entitled to a second or third opinion as I got at the beginning of this week. Get another opinion. Take regular photos of it so you can monitor any changes.

Second this. Looks nothing like shingles.

Looks like it could be a rodent ulcer-get it looked at asap. www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwjm28X4j4b6AhXUnVwKHf35BbYQFnoECCMQAQ&url=https%3A%2F%2Fwww.shutterstock.com%2Fsearch%2Frodent-ulcer&usg=AOvVaw1N--Pw4iGu6r-jvBKPcm-M

Jesus what sort of GP would say it's shingles! Have they never even used Dr Google to look at pictures of different skin disorders never mind the million years at uni?? Terrifying

100% second opinion. Keep us posted

Maybe the sort of GP who has heard of herpes zoster oticus? See my earlier posts.

Everyone saying confidently that this isn't shingles is talking out of their arse. It might be shingles, it might not. But those of you slagging off the GP are just showing your own ignorance.

Apologies for not reading the full thread and sorry you're dealing with this...but...a trigger warning for the photo would have been good...
(I know I know but some of us are sensitive!!!)

@RichPetunia I think a really essential point that those of us who are very concerned it isn’t shingles vs. those who has said, “Shingles can be a dark color and cause pain like that,” (because no, they’re not wrong, and yes, shingles can cause Ramsey Hunt syndrome), is that it appears to me that is a pitted wound. It is not level with the skin at all. Only you know for sure, since none of us can see it in person. Unless something is deeply wrong, shingles should not cause open, pitted wounds, that are dark black in color, not even herpes zoster oticus. When you look at the pictures for herpes zoster oticus, the type that attacks the nerve by the eyes, it may cause shingles like this near the eyes, it may cause dark shingles, but it does not cause a dark, black, pitted wound like this. I assume they did a blood test and it was active for shingles which is how they know this, and why they’re saying it’s shingles. I would just check and make sure she’s had the blood test and that’s why they’re so certain and being dismissive. And even so, it still looks like a necrotic wound that needs treatment to me. And be aware there may be some ageism at play - shingles treatment sometimes has some. Doctors are more worried about facial paralysis affecting a 30 year old permanently than an 80 year old. Which is wrong; they’re both allowed the same quality of life, and duty of care. The type of pain you’re talking about, if it is caused by shingles needs to be treated in a very specific way (with not just antibiotics but also steroids) or it could cause her facial numbness and pain for the rest of her life. The trigeminal nerve is RIGHT under where this wound is so I assumed her doctor should be treating it very actively to make sure it doesn’t get deeper, and trying to stop it from getting worse, period, as pain in your trigeminal nerve is known to be absolutely unbearable. For all these reasons, I would ask for a second opinion, ASAP, whether it’s shingles or not. And if they don’t have a blood test showing she has shingles, I would want that second opinion immediately.

I do hope, whatever it is, she gets better soon! Good luck, OP.

What the hell is wrong with some doctors? That is nowhere near shingles.

Go to another doctor, not social media!

@MissLucyEyelesbarrow And you’re right about “slagging off the GP.” I hope I didn’t in my first comment; I just found the photo a bit shocking. I still don’t think an open, pitted wound is likely to be HZ oticus, BUT if a blood test was positive for HZ and the GP has the knowledge of that (as I said in my second comment), then it makes sense that they’re advising it’s shingles.

I just would still say it needs urgent treatment, placed as it is directly over the trigeminal nerve (with everything we know medically about trigeminal neuralgia, not that I want to scare OP), and with the pain OP’s mother is describing. BUT maybe the GP is doing all that (another reason not to “slag them off” - OP didn’t mention the GP’a treatment; perhaps they’re giving the correct treatment to try to handle that issue).

@5YearsLeft Your core point - that it is important that the skin lesion is safely managed, whatever the diagnosis is - is a good one. And I agree that it is important to keep an open mind about the diagnosis

But you are being far too definitive by making statements like, "it may cause dark shingles, but it does not cause a dark, black, pitted wound like this".

The presentation of shingles is incredibly varied. Gruesome photos warning, but here is another set of photos of how shingles can present on the face. It absolutely can cause dark, pitted lesions.

There are certainly other possibilities, some of which have been mentioned on here. I am not diagnosing the OP's Mum. But I am saying that shingles is a possibility, and you anyone shouting otherwise on here is demonstrating that they do not understand how varied the presentation of shingles can be.

PS @5YearsLeft I didn't mean you were slagging off the GP. I meant some other posters. As I said, your core points are good ones.

I'd be more inclined to listen to the GP who has seen it in person rather than unqualified randoms on the internet ...

By all means, ask for a second opinion and you're probably very wise to do so. I'd do exactly the same

But I'd also probably try and drown out some of the non doctors on here who are keen to tell you it can't possibly be shingles when yes, it absolutely can be

That looks nasty get it checked out by another dr and as soon as. Good luck.

The two week rule doesn’t apply in dermatology. . Generally when these sort of lesions present the GP sends a photo to the local hospital dermatology dept and the photos are triaged by a dermatologist who decides how urgently they need to be seen. Many skin cancers don’t spread or if they do spread its very slowly. Contrary to popular opinion most melanoma are caught in the early stages and are very treatable.
As we get older it is very common for us to develop areas of sun damaged skin on our faces and these may be cancerous or even pre cancerous and treatment is relatively easy often they are incised under local anaesthetic in out patients depts although some do go to plastic surgeons but again all done as a day case and the cancer is complete removed and that is the end of it.
Don’t go asking non dermatologist who know literally nothing on the internet about the lesion on your mothers face, go back to the GP and ask for a good clear photo to be referred/emailed to those who do know what they are talking about: your local hospital dermatology dept and they will advise accordingly on how urgently it needs to be seen.

Strange my doctor referred me to dermatology under the 2 week rule. Dermatology saw me within a week and I had the biopsy a week after that. It was definitely my Dr who started the 2 week ball rolling not dermatology.

get second opinion ASAP

The two week rule doesn’t apply in dermatology

That will come as a surprise to the nation's dermatologists, who see half a million people a year under the 2 week referral scheme. It is, in fact, the most heavily used two week referral pathway in the NHS.

Just an idea OP - you could download the Skin Vision app, take a picture of this lesion with it and use the results in your next GP appointment. Definitely not shingles! The Skin Visio app is amazing for picking up abnormalities.

@MissLucyEyelesbarrow I understand what you mean and you may absolutely be right. I’ve gone ahead and looked through the link, plus personal experience and it’s pretty much what I thought and I don’t disagree - shingles are extremely varied in presentation. But even in all the images on that link, and considering the absolute shiteload of shingles I’ve seen in person, and some quite nasty outbreaks, I just felt like I couldn’t find one that had the same look of a deep open wound, in dark black color, with defined edges, as OP’s mother does. (Lots that were dark, lots that were wounds, some that were open wounds, tons with and without defined edges, and one bloke 3/4s down the link on a paper about chronic mucocutaneous herpes simplex virus that had black wounds like that, but still not deep, black, pitted, and open combined). What I HAVE seen that looked like OP’s mum’s spot: either melanomas in stage III+ OR regular shingles that have begun to go necrotic for some reason. I suppose that’s what I was concerned about. But I also know I’d be an idiot to assume I’ve seen every variation of shingles in existence, even if I tried every link, so if you’ve seen something like this, I completely accept that. And I think anyone would be concerned, shingles or no, due to its placement. I mean, with where it’s located, with the symptoms described, we all know what OP’s mother is in for if it’s not treated correctly and in a timely manner. But I agree that you’re absolutely right: none of us can diagnose OP’s mother, and none of us know if her GP is already treating her correctly. We can do two things:

1. Encourage OP to check into what information the GP used to make this diagnosis. As I stated, a positive active shingles blood test would make this all make much more sense re: shingles diagnosis.
2. Encourage OP to ask for a second opinion or just for more active treatment if the GP is not treating this actively enough, even if there is a positive shingles test, because OP’s mum should have a doctor who is actively “looking in on” her trigeminal nerve.

It could be that the GP is already taking an active approach to treating this, and will biopsy the spot if there’s no improvement in a week, or something. And OP should hopefully have enough information now to discuss it.

I’m not going to bore you with how I know this but you’ll just have to accept what Im saying is true. I’m not saying they won’t see you in two weeks but they cannot possibly see all possible cancerous lesions referred to them in 2 weeks there simply are enough dermatologist in the UK to do this. So yes the GP makes the referral and may state it’s urgent but as most GPs only have a day of dermatology training in their entire career (if your lucky) a dermatologist will then look at the referral and hopefully a good clear photo of said lesion and decide how “urgent” it needs to be. Many skin lesions are cancerous but will not spread anywhere so these do not need to be seen under the two week rule. Others are more serious but again can wait more than two weeks because they do not spread that quickly. Possible melanomas are hopefully seen within two weeks of the referral being made.

Just to add the dermatology dept in my hospital (and it’s relatively small in the grand scheme of things) gets 30 + referrals from GPs of lesions a day they simply cannot see all under the 2 week rule there are not enough of them dermatologist are a rare species in the world of medicine or enough clinic hours in the week.
My hospital receives referrals from numerous GP surgeries and only one would do a biopsy in the surgery and that GP is about to retire. Most patients presenting with lesions are not biopsies and then excised at a later date they are only excised, dermatologist are pretty good at deciding what looks dodgy (although they may always not be able to state exactly what sort of cancer the lesion is) and what it just a harmless non malignant lesion