title: Is there just one lesion? The need for whole body skin examination in patients presenting with non-melanocytic skin cancer.
abstract: BACKGROUND
  In patients presenting with non-melanoma skin cancer (NMSC) the frequency of concurrently presenting tumours is poorly documented. Whole body skin examination is recommended but in a recent survey of Australian General Practitioners and skin cancer clinics doctors it was infrequently performed. The aim of this study was to examine the incidence of concurrent skin cancer at initial presentation and therefore to examine the need for whole body skin examination for NMSC presentations.
  
  
  METHODS
  One hundred consecutive patients with a referral diagnosis indicative of NMSC were examined. Data was analysed as to the referring doctor's diagnosis, whole body skin examination findings and histology of excised lesions. Epidemiological data was obtained by patient questionnaire.
  
  
  RESULTS
  One hundred patients, 41 males and 59 females, with a mean age of 70 years (range 39-91 years) underwent whole body skin examination. Sixty-seven per cent of patients were found to have additional lesions requiring treatment, 46% sin cancers (30 patients basal cell carcinomas, five squamous cell carcinomas, seven basal and squamous cell carcinomas, two lentigo maligna, two adenexal tumours) and 21% solar keratoses. Thirty-four of the additional lesions detected were in areas covered by clothing. Sixty-eight patients had a past history of skin cancer excision.
  
  
  CONCLUSIONS
  In the Australian patient population, the need for whole body skin examination is essential to avoid missing concurrent lesions. Ongoing surveillance is also essential as these patients have a high risk of developing future NMSC.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Frankston Hospital, Peninsula Health, Melbourne, Australia. pjt@29specialist.com.au
authors.forename: Patricia Jane
authors.initials: PJ
authors.lastname: Terrill
authors.forename: Sian
authors.initials: S
authors.lastname: Fairbanks
authors.forename: Michael
authors.initials: M
authors.lastname: Bailey
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010808:Physical Examination / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D011795:Surveys and Questionnaires