Most Nondermatologist Lesion Referrals Are Nonmalignant

But consulting dermatologists are better able to identify incident malignant lesions

WEDNESDAY, May 18 (HealthDay News) -- Nondermatologist referrals for skin malignancies include mainly noncancerous lesions, but consulting dermatologists are better able to identify incident malignant lesions in addition to the primary lesion of concern, according to a study published in the May issue of the Archives of Dermatology.

Kate V. Viola, M.D., from the Yale University School of Medicine in New Haven, Conn., and colleagues examined the proportion of suspicious lesions referred by nondermatologists that are found to be malignant, and the number of incidental skin cancers identified during dermatology referrals. Data were collected from 400 patients, referred by nondermatologists, with 400 skin lesions suspected of being malignant from 2006 through 2009. Outcome measures included the referring provider, final diagnosis by the dermatologist, and the number and type of incidental lesions.

The investigators found that, in total, 98 patients had 149 cancerous lesions. Of these cancerous lesions, 88 were identified from the 400 index lesions that prompted the referral, and 61 were found when the consulting dermatologists biopsied an additional 111 incidental lesions. In 12 patients, an incidental lesion was biopsied and found to be malignant, but the index lesion was clinically benign and was not biopsied.

"Nondermatologists may benefit from focused educational initiatives on skin cancer detection," the authors write. "A substantial proportion of malignant lesions was incidentally identified by the consulting dermatologist in addition to the primary lesion of concern."

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