Background Few studies have evaluated the detection of incidental skin cancers. Objective We sought to evaluate the rate of incidental cutaneous malignancies in routine dermatology consults. Methods This was a retrospective chart review of all dermatology consults at the Minneapolis Department of Veterans Affairs Medical Center over 8.25 years. Inclusion criteria included an in-person clinic visit within 18 months of the initial consult date. Patients with an in-person skin examination by a dermatologist in the 18 months before consult date were excluded. Results Of 28,405 consults sent during the study period, 17,174 met inclusion criteria. In all, 2257 (13.1%) patients had 1 or more biopsied incidental lesions. Half (50.3%; n = 1674) of the 3328 biopsied incidental lesions were malignant, which included 1187 patients. The per-person detection rate for an incidental malignant lesion was 6.9% (1187/17,174). There were 87 incidental melanomas identified in 84 patients. The per-person detection rate for an incidental melanoma was 0.5% (84/17,174). The most frequent anatomical location for biopsied incidental malignancies was the head and neck (53.9%). Incidental melanomas were most frequently located on the back (33.3%). Limitations Nondiverse patient population and conservative detection rate estimates are limitations. Conclusion An in-person skin examination by a trained dermatologist is important for detection of skin malignancies. This may have implications for teledermatology.
Bibliographical noteFunding Information:
This material is based upon work, supported in part, by the Minneapolis Department of Veterans Affairs Medical Center . There are no other sources of funding for this work. The contents of this publication do not represent the views of the Department of Veterans Affairs or the US Government.
Copyright 2015 Elsevier B.V., All rights reserved.
- Key words dermatology consults
- nonmelanoma skin cancer
- skin cancer