title: Pathology referrals for skin lesions--are we giving the pathologist sufficient clinical information?
abstract: OBJECTIVE
  To assess the quality of data included in the histology request form.
  
  
  METHODS
  We prospectively reviewed the histology request forms of 375 consecutive skin lesions. In addition, the appropriateness of the surgical specimen was determined.
  
  
  RESULTS
  There were 196 women and 179 men with a mean age of 58.4 years. The majority of specimens (84.5%) derived from primary care. 233 lesions (62%) were removed by excision, 57 (15%) by shave, three by curettage, with 82 lesions (22%) by punch/incisional biopsy. The clinical diagnosis was either not specified in 56 cases (15%), or simply labelled as 'lesion' in 84 (22%) patients. In 140/375 cases (37%), no useful clinical information was available. The clinical diagnosis matched the histopathological diagnosis in 145 cases (39%). Sixty percent (78/131) of histologically confirmed malignant lesions had not been identified clinically as being malignant: only 2 of 12 (17%) melanomas, 33/74 (45%) BCCs and 18/45 SCCs (57%) were diagnosed clinically. The specimen type was considered inadequate to make a histopathological diagnosis in 25 cases (6.7%).
  
  
  CONCLUSIONS
  In over a third of histology requests, diagnostic clinical information was absent. In addition, punch biopsy was used in 40% of lesions where a melanoma was being considered clinically.
authors.affiliation: Dermatology Department, Waikato Hospital, Hamilton, New Zealand. Marius.Rademaker@waikatodhb.health.nz
authors.forename: Marius
authors.initials: M
authors.lastname: Rademaker
authors.forename: Murray
authors.initials: M
authors.lastname: Thorburn
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002648:Child; D002983:Clinical Competence; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012017:Referral and Consultation; D015203:Reproducibility of Results; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery; D055815:Young Adult