title: Evaluation of prospectively collected presenting signs/symptoms of biopsy-proven melanoma, basal cell carcinoma, squamous cell carcinoma, and seborrheic keratosis in an elderly male population.
abstract: BACKGROUND
  Presenting signs/symptoms of skin cancer may aid in earlier detection and diagnosis.
  
  
  OBJECTIVE
  We sought to compare prospectively collected, presenting signs/symptoms of malignant melanoma (MM), basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and seborrheic keratosis (SK).
  
  
  METHODS
  This analysis was part of a larger study on teledermatology involving 3039 skin neoplasms in 2152 patients at a Department of Veterans Affairs medical center. At presentation, participants were asked about signs/symptoms of specific skin lesions. In all, 912 biopsy-proven MM (39), BCC (411), SCC (238), and SK (224) were included in this analysis. Pearson chi(2) analyses were used to test associations of lesion type and specific signs/symptoms in pairwise comparisons.
  
  
  RESULTS
  "No symptoms" was reported more often with MM (82%) as compared with BCC (relative risk [RR] 2.26, confidence interval [CI] 1.86, 2.75), SCC (RR 3.31, CI 2.54, 4.32), or SK (RR 2.0, CI 1.61, 2.48; all P < .0001). Tenderness was more commonly reported with SCC (40%) as compared with MM (RR 15.9, CI 2.28, 110.69), SK (RR 3.0, CI 2.11, 4.39), or BCC (RR 2.6, CI 1.97, 3.38; all P < .0001). Bleeding was more commonly reported with BCC (37%) as compared with SK (RR 2.3, CI 1.67, 3.20), SCC (RR 1.6, CI 1.22, 2.05), or MM (RR 29.8, CI 1.89, 469.65; all P <or= .007).
  
  
  CONCLUSIONS
  The small number of MM and study population characteristics (elderly, Caucasian, male) limit generalizability.
  
  
  CONCLUSIONS
  This study describes common signs/symptoms of BCC, SCC, and SK. Our findings suggest that MM may be asymptomatic more often than previously recognized.
authors.affiliation: Department of Dermatology at Minneapolis Veterans Affairs Medical Center, MN 55417, USA.
authors.forename: Sharone K
authors.initials: SK
authors.lastname: Askari
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Schram
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Wenner
authors.forename: Sacharitha
authors.initials: S
authors.lastname: Bowers
authors.forename: An
authors.initials: A
authors.lastname: Liu
authors.forename: Ann K
authors.initials: AK
authors.lastname: Bangerter
authors.forename: Erin M
authors.initials: EM
authors.lastname: Warshaw
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002280:Basal Cell Carcinoma / Q000175:diagnosis*; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis*; D006801:Humans; D017492:Keratosis, Seborrheic / Q000175:diagnosis*; D008297:Male; D008545:Melanoma / Q000175:diagnosis*; D008875:Middle Aged; D011446:Prospective Studies; D012871:Skin Diseases / Q000175:diagnosis*; D012878:Skin Neoplasms / Q000175:diagnosis