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Who removes pigmented skin lesions?
R Marks1, D Jolley, C McCormack
1University of Melbourne, Department of Medicine (Dermatology), St Vincent's Hospital, Fitzroy, Australia.
Journal of the American Academy of Dermatology
|May 1, 1997
Summary
Physicians struggle to distinguish benign from malignant pigmented skin lesions, particularly general practitioners. While some improvement was noted for melanocytic nevi, better differentiation of seborrheic keratoses and melanomas is needed.
Area of Science:
- Dermatopathology
- Medical Education
Background:
- Rising concern over potential skin cancer leads to increased removal of pigmented lesions.
- Accurate diagnosis of pigmented lesions is crucial for patient management.
Purpose of the Study:
- To assess the ratio of benign to malignant pigmented tumors removed by different physician types.
- To evaluate the impact of 5-year educational programs on diagnostic accuracy.
Main Methods:
- Analysis of pigmented lesions submitted to a histopathology service in 1989 and 1994.
- Categorization of lesions by physician type, tumor type, patient age, and sex.
Main Results:
- Dermatologists had the lowest benign/malignant ratio; general practitioners had the highest.
- General practitioners showed difficulty distinguishing seborrheic keratoses and melanocytic nevi from malignant lesions.
- A 5-year improvement in the benign/malignant ratio for melanocytic nevi was observed among general practitioners, but not for seborrheic keratoses.
Conclusions:
- Physicians, especially general practitioners, require enhanced training in differentiating benign pigmented lesions (melanocytic nevi, seborrheic keratoses) from melanomas.
- Improved diagnostic skills are essential, particularly as the public often seeks initial advice from general practitioners for suspicious lesions.