Effect of preoperative evaluation by a dermatologist on diagnostic accuracy

The accuracy of the diagnosis of skin lesions has an important effect in outcomes in treatment selection and prioritization of the treatment.

To assess the effect of preoperative evaluations by dermatologists on the diagnostic accuracy of plastic surgeons.

A retrospective analysis was performed on 1,146 biopsies that were excised by plastic surgeons in our secondary State Hospital. The histopathologic diagnoses were divided into 2 groups according to the preoperative dermatological evaluation, with Group 1 being the lesions that were evaluated by a dermatologist before excision and Group 2 being the lesions that were not evaluated by a dermatologist before excision. The sensitivity and positive predictive values (PPVs) were calculated and compared between the 2 groups using Fisher exact test.

The PPVs of the malignant lesions of Groups 1 and 2 were 53.8% and 25.0%, respectively (p = .001). When Group 1 was contrasted with Group 2, the PPVs for the premalignant lesions were 71.4% and 46.8%, respectively (p = .015). The PPV for the benign lesions was 86.3% in Group 1 and 72.6% in Group 2 (p < .001).

This study demonstrated that the diagnostic accuracy of plastic surgeons was affected positively by preoperative evaluations by a dermatologist.