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.
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.
Askari
Sharone K
SK
Department of Dermatology at Minneapolis Veterans Affairs Medical Center, MN 55417, USA.
Schram
Sarah E
SE
Wenner
Rachel A
RA
Bowers
Sacharitha
S
Liu
An
A
Bangerter
Ann K
AK
Warshaw
Erin M
EM
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