title: Palpation as a useful diagnostic tool for skin lesions.
abstract: BACKGROUND
  Early identification and accurate diagnosis of malignant pigmented skin lesions is essential for effective management and cost containment. The aim was to investigate the additional value of tactile descriptive information from lesion palpation on the diagnostic accuracy of pigmented skin lesions by medical students using computer-driven learning.
  
  
  METHODS
  Sixth year medical students (n = 152) from the University of Adelaide were invited to participate in an online teaching module on pigmented skin lesions. Users were asked to describe, diagnose and manage 15 pigmented skin lesions in three separate case studies based on pertinent clinical history and visual images of the lesions. Tactile descriptive information was then provided and users were asked to reflect on their diagnosis and management.
  
  
  RESULTS
  A total of 66 (43%) of the sixth year students successfully completed the online module. Diagnostic accuracy improved significantly with the provision of tactile descriptive information for seborrhoeic keratosis (p = 0.012), basal cell carcinoma (p = 0.001), squamous cell carcinoma (p = 0.02), and dysplastic naevi (p = 0.035). Tactile descriptive information was stated by 23% of medical students to be important in the clinical diagnosis of pigmented skin lesion. Students managed all malignant pigmented skin lesions with either appropriate biopsy or specialist referral.
  
  
  CONCLUSIONS
  Palpation information about skin lesions offers useful information for improvement of diagnostic accuracy in an online computer learning setting for medical students.
authors.affiliation: Discipline of Surgery, University of Adelaide, Royal Adelaide Hospital, North Terrace, Adelaide 5000, South Australia, Australia. Electronic address: puvesh@gmail.com.
authors.forename: Puvesh
authors.initials: P
authors.lastname: Punj
authors.affiliation: Discipline of Surgery, University of Adelaide, Royal Adelaide Hospital, North Terrace, Adelaide 5000, South Australia, Australia.
authors.forename: Peter G
authors.initials: PG
authors.lastname: Devitt
authors.affiliation: Discipline of Surgery, University of Adelaide, Royal Adelaide Hospital, North Terrace, Adelaide 5000, South Australia, Australia.
authors.forename: Brendon J
authors.initials: BJ
authors.lastname: Coventry
authors.affiliation: Discipline of Surgery, University of Adelaide, Royal Adelaide Hospital, North Terrace, Adelaide 5000, South Australia, Australia.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Whitfield
mesh_terms: D002280:Basal Cell Carcinoma / Q000175:diagnosis; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis; D003198:Computer Simulation; D003880:Dermatology / Q000193:education; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D003937:Diagnosis, Differential; D004504:Education, Medical, Undergraduate / Q000379:methods; D004521:Educational Measurement; D005260:Female; D006801:Humans; D017492:Keratosis, Seborrheic / Q000175:diagnosis; D008297:Male; D008545:Melanoma / Q000175:diagnosis; D009508:Nevus, Pigmented / Q000175:diagnosis*; D010173:Palpation / Q000379:methods*; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000175:diagnosis*; D013337:Students, Medical; D055815:Young Adult
keywords: Pigmented; Skin lesions; Tactile; Texture