WHO REMOVES PIGMENTED SKIN-LESIONS

Background: Increasing numbers of pigmented skin lesions are being rem oved because of concern about possible malignancy. Objective: Our purp ose was to determine the ratio of benign to malignant pigmented tumors removed by different categories of physician and to verify whether an y improvement had occurred after 5 years of educational programs. Meth ods: All pigmented lesions submitted to a major histopathology service in the years 1989 and 1994 were assessed as to the category of physic ian who removed the lesion, tumor type, and age and sex of the patient . Results: Dermatologists had the lowest benign/malignant ratio and ge neral practitioners had the highest. General practitioners appeared to have difficulty differentiating both seborrheic keratoses and melanoc ytic nevi from malignant lesions; the frequency of these benign lesion s was highly dependent on the age of the patient. During the 5-year pe riod we observed an improvement among general practitioners in the ben ign/malignant ratio for melanocytic nevi, but not for seborrheic kerat oses. Conclusion: There is room for improvement by physicians in diffe rentiating both melanocytic nevi and seborrheic keratoses from melanom as. This is especially true for general practitioners, from whom the p ublic in Australia and in other countries is encouraged to first seek advice about a suspect pigmented lesion.