Mjm. Derooij et al., TOTAL SKIN EXAMINATION DURING SCREENING FOR MALIGNANT-MELANOMA DOES NOT INCREASE THE DETECTION RATE, British journal of dermatology, 135(1), 1996, pp. 42-45
Total skin examination during public screening for malignant melanoma
is often advocated, but the benefit of this approach has not been esta
blished properly. We assessed the yield of examination of the entire s
kin, in addition to examination of intentionally shown skin lesions, i
n people attending melanoma screening clinics in southern Limburg, the
Netherlands, in 1993. Of the 4146 attenders, 2910 (70%) showed a spec
ific skin spot. Additional examination of the entire skin was offered
to 1385 people. There were 1221 evaluable cases. Fourteen presumptive
diagnoses of malignancies were encountered: seven malignant melanomas,
all with low clinical suspicion, and seven basal cell carcinomas. His
tology revealed three basal cell carcinomas. No malignant melanomas we
re confirmed by histology. It is concluded that additional total skin
examination during screening for malignant melanoma is not worthwhile,
except perhaps for persons presenting lesions that are suspicious of
melanoma or dysplastic naevi.