Basal cell carcinoma what to do?

I have been found to have a small BCC on my left temple. My count is around 11. The dermatologist gave me a prescription for a cream called Aldara but having researched it I find that it is contra- indicated for those who already have have haema problems and also that it may not work on those who have had Rituximab eg me. Anyone else been in this position? Has anyone had a BCC removed surgically, ether by MOHs microsurgery or traditional excision with such a low count?

Margaret, I'd call both your Dermatologist and Hematologist and ask for alternative options. One of them can surely come up with a good plan; better than any advice any of us could give.

Margaret,

If you view a youtube, the procedure for removing BCC does not look very bloody. Does your dermatologist have a minimal platelet count to do the procedure?

Since your ITP is unresponsive to steroids, and only marginally responsive to Rituxan, I thought you might be interested in reconsidering Dapsone, perhaps just for long enough to get your platelets up for minor surgery, if not long term. Just a thought...

onlinelibrary.wiley.com/doi/10.1002/ajh.22266/full
Dapsone salvage therapy for adult patients with immune thrombocytopenia relapsed or refractory to steroid and rituximab
Francesco Zaja*, Luciana Marin, Marianna Chiozzotto, Simona Puglisi, Stefano Volpetti and Renato Fanin
American Journal of Hematology Volume 87, Issue 3, pages 321–323, March 2012

Dapsone is an antibacterial sulfonamide with anti-inflammatory property, which showed therapeutic activity in patients with immune thrombocytopenia (ITP) [1–6]; the activity in patients who showed refractoriness to rituximab is unknown. We evaluated the effect of dapsone in 20 consecutive adult patients, median age 51 years, with primary ITP previously treated at least with steroids and rituximab. Median baseline platelet count was 19 × 109/L, and the median interval between diagnosis of ITP and dapsone therapy was 46 months. Response (platelet count ≥ 30 × 109/L) and complete response (CR; platelet count ≥ 100 × 109/L) were 55 and 20%, respectively; median time to response (TTR) was 1 month. All responders were able to interrupt any other specific anti-ITP treatment.....

Thanks both of you. Rob, you are the fount of all knowledge! I will be contacting dermatologist, plastic surgeon, and haema but just wanted to know if there was any experience out there. I would have to go to a near bye city for MOHs microsurgery but will phone and
get an opinion. I have now found a protocol for vulnerable patients on the web.

Just in case anyone finds themselves with the same problem , the least harmful / invasive options for ITP sufferers are cryotherapy with liquid nitrogen and photo dynamic therapy. I have tried the freezing method first to see if it works.