Effect of preoperative evaluation by a dermatologist on diagnostic accuracy.

Background: The accuracy of the diagnosis of skin lesions has an important effect in outcomes in treatment selection and prioritization of the treatment.

Objective: To assess the effect of preoperative evaluations by dermatologists on the diagnostic accuracy of plastic surgeons.

Materials And Methods: A retrospective analysis was performed on 1,146 biopsies that were excised by plastic surgeons in our secondary State Hospital. The histopathologic diagnoses were divided into 2 groups according to the preoperative dermatological evaluation, with Group 1 being the lesions that were evaluated by a dermatologist before excision and Group 2 being the lesions that were not evaluated by a dermatologist before excision. The sensitivity and positive predictive values (PPVs) were calculated and compared between the 2 groups using Fisher exact test.

Results: The PPVs of the malignant lesions of Groups 1 and 2 were 53.8% and 25.0%, respectively (p = .001). When Group 1 was contrasted with Group 2, the PPVs for the premalignant lesions were 71.4% and 46.8%, respectively (p = .015). The PPV for the benign lesions was 86.3% in Group 1 and 72.6% in Group 2 (p < .001).

Conclusion: This study demonstrated that the diagnostic accuracy of plastic surgeons was affected positively by preoperative evaluations by a dermatologist.