title: Assessment of clinical diagnostic accuracy compared with pathological diagnosis of basal cell carcinoma.
abstract: BACKGROUND
  Basal cell carcinoma (BCC) is the most common type of skin cancer, afflicting light skin more than dark skin people. This malignancy metastasizes rarely and has unique histological properties.
  
  
  OBJECTIVE
  We focused on the accuracy of clinical diagnoses of BCC by specialists.
  
  
  METHODS
  Patients' information for 4-year period between 2007 and 2011 was extracted from files at a Pathology Department. The results were analyzed using the Chi-square method and SPSS software.
  
  
  RESULTS
  From 367 referred cases dermatologists diagnosed 41% as direct BCC cases, 43.4% through excluding other skin diseases, 4% incorrectly and 1.11% unidentified. For other specialists (including plastic surgeons, ophthalmologists, general surgeons, and general practitioners) these were respectively 47.8%, 22.4%, 6.3% and 23.5%. Dermatologists had diagnosed 107 cases of all skin diseases as BCC through clinical examination of which 78.5% were correctly and 21.5% incorrectly diagnosed. The same parameters for all other specialists were respectively 77.36% and 22.64%. Diagnostic sensitivity, positive reportability, clinical conjecture indicator (CCI) and clinical diagnostic indicator were respectively 84.4%, 78.5%, 121.5% and 75.6%; whereas for other specialists these indicators were 70 among cases diagnosed by dermatologists as BCC, where pathological results showed other causes. The most common diagnosis by pathologists and other specialists was reported as squamous cell carcinoma (SCC). Among cases not diagnosed by dermatologists as BCC, where pathological results indicated BCC, the most common clinical diagnosis was malignant melanoma by dermatologists and SCC by other specialists.
  
  
  CONCLUSIONS
  Dermatologists diagnosed BCC with higher sensitivity and positive reportability; also, CCIs and clinical diagnostic correctness was higher among dermatologists. The necessity for consulting with dermatologists and referring all skin diseases samplings to pathologist is thus clearly visible.
authors.affiliation: Department of Dermatology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Ebrahimzadeh-Ardakani
authors.initials: EA
authors.lastname: Mohammad
authors.affiliation: Department of Pathology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Moghimi
authors.initials: M
authors.lastname: Mansour
authors.affiliation: Department of Dermatology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Kafaie
authors.initials: K
authors.lastname: Parichehr
authors.affiliation: Department of Dermatology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Dehghani
authors.initials: D
authors.lastname: Farideh
authors.affiliation: Department of Dermatology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Rashidi
authors.initials: R
authors.lastname: Amirhossein
authors.affiliation: Researcher, Yazd Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Shojaoddiny-Ardekani
authors.initials: SA
authors.lastname: Ahmad
keywords: Basal cell carcinoma; clinical diagnosis; pathological diagnosis