Who removes pigmented skin lesions?
BACKGROUND
Increasing numbers of pigmented skin lesions are being removed because of concern about possible malignancy.


OBJECTIVE
Our purpose was to determine the ratio of benign to malignant pigmented tumors removed by different categories of physician and to verify whether any improvement had occurred after 5 years of educational programs.


METHODS
All pigmented lesions submitted to a major histopathology service in the years 1989 and 1994 were assessed as to the category of physician who removed the lesion, tumor type, and age and sex of the patient.


RESULTS
Dermatologists had the lowest benign/malignant ratio and general practitioners had the highest. General practitioners appeared to have difficulty differentiating both seborrheic keratoses and melanocytic nevi from malignant lesions; the frequency of these benign lesions was highly dependent on the age of the patient. During the 5-year period we observed an improvement among general practitioners in the benign/malignant ratio for melanocytic nevi, but not for seborrheic keratoses.


CONCLUSIONS
There is room for improvement by physicians in differentiating both melanocytic nevi and seborrheic keratoses from melanomas. This is especially true for general practitioners, from whom the public in Australia and in other countries is encouraged to first seek advice about a suspect pigmented lesion.
Marks
R
R
University of Melbourne, Department of Medicine (Dermatology), St Vincent's Hospital, Fitzroy, Australia.
Jolley
D
D
McCormack
C
C
Dorevitch
A P
AP
D000328:Adult; D001315:Australia; D003625:Data Collection; D003880:Dermatology; D003937:Diagnosis, Differential; D005194:Family Practice; D005260:Female; D013502:General Surgery; D006801:Humans; D017492:Keratosis, Seborrheic / Q000175:diagnosis / Q000601:surgery; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000601:surgery*; D008875:Middle Aged; D009508:Nevus, Pigmented / Q000175:diagnosis / Q000601:surgery*; D012878:Skin Neoplasms / Q000175:diagnosis / Q000601:surgery*; D013518:Surgery, Plastic