[Malignant skin tumours in a private dermatology practice. A quality control study].
OBJECTIVE
The campaign for early detection of malignant melanoma and the increase in people with photodamaged skin have a remarkable influence on the daily dermatological routine. Could these factors lead to the introduction of quality control in a private dermatology practice?


METHODS
Over a period of one year the diagnoses of all patients were registered. The clinical diagnosis of any skin tumour undergoing surgical removal was compared with the final histopathological diagnosis.


RESULTS
56% of 3004 diagnoses involved females; 44%, males. In 40.5%, the possibility of a pigmented or non-pigmented skin tumour was raised. 49% of the 291 tumours removed were malignant (107 basal cell carcinoma, 20 squamous cell carcinoma, 16 melanoma) while 11.7% were malignant precursor lesions. 48% of 44 melanocytic naevi with clinical atypia showed histopathological dysplasia but none were a malignant melanoma. No cancers were detected among 59 clinically benign tumors. In 71.8% of cases, the clinical diagnosis agreed with the result of the histopathological examination.


CONCLUSIONS
This study shows, in concordance with literature, that a dermatologist can provide high quality treatment and prophylaxis of malignant skin tumours. With an optimal cost-performance ratio, he or she is the most competent partner for patients and health insurance companies.
Hofer
T
T
Dermatologie FMH, Wettingen, Germany. thomas.hofer@active.ch
D002280:Basal Cell Carcinoma / Q000473:pathology / Q000517:prevention & control / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000517:prevention & control / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000517:prevention & control / Q000601:surgery; D009508:Nevus, Pigmented / Q000175:diagnosis; D011230:Precancerous Conditions / Q000517:prevention & control; D011786:Quality Control; D011787:Quality of Health Care; D012737:Sex Factors; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery