Background/objectives: An e-referral system was developed at a tertiary care hospital in Auckland, New Zealand in 2014 for suspected cutaneous malignancy. E-referrals include patient information, a description of the lesion(s), biopsy results and/or attached photograph(s). Experienced surgical oncologists prioritised the referrals and selected a management option or referred them for a teledermatoscopy opinion. Our aim was to review the efficacy of e-referrals for improving diagnostic accuracy for melanoma.
Methods: Referrals received in 2016 including images and categorisation as confirmed, likely or suspected melanoma by the triage specialist were evaluated. Concordance of the pathological diagnosis with the triage diagnosis and teledermatoscopy diagnosis was determined for each referral.
Results: 809 of 3470 e-referrals for skin cancer were categorised as confirmed, likely or suspected melanoma. 230 (28.4%) of these included a referral histopathology confirming melanoma/melanoma in situ. Of the remaining 579 referrals, 315 were sent for urgent diagnostic excision and 264 were referred for teledermatoscopy. 120 of the 315 sent for urgent excision were confirmed as melanoma (53) or melanoma in situ (67) on histopathology: a positive predictive value (PPV) of 38.1% and number needed to excise (NNE) of 2.6. Less than 10% of referrals triaged for teledermatoscopy were confirmed as melanoma (24/264). Almost half of all referrals (374/809, 45.6%) included melanoma/melanoma in situ. The melanoma: melanoma in situ ratio was 1: 1.18.
Conclusions: The e-referral and teledermatoscopy service for suspected melanoma has proven fewer unnecessary excisions of benign lesions than previously reported.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/ajd.13230 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Trauma-Associated Pseudo-Hutchinson Sign: An Autobiographical Case Report Emphasizing Conditions, Pseudo-Conditions, and Pseudo-Pseudo-Conditions.
Cureus
December 2024
Dermatology, University of California, Davis Medical Center, Sacramento, USA.
Melanonychia describes black pigmentation of the nail plate that results from either melanocyte activation (such as infections, local inflammatory disorders, local trauma affecting the nail plate, numerous systemic conditions, and medications) or melanocyte hyperplasia (such as benign neoplasms or malignant tumors) or blood (resulting from a trauma-associated subungual hematoma). The black dyschromia may include not only the nail plate but also the proximal nailfold. The Hutchinson sign refers to black discoloration of both the proximal nailfold and adjacent nail plate when the underlying pigmented lesion is a malignant melanoma.
View Article and Find Full Text PDFDiagnostic and Prognostic Challenges of Oral Melanoma in Dogs: A Literature Review and 2 Case Studies.
J Vet Dent
January 2025
Specialty Oral Pathology for Animals, Geneseo, IL, USA.
Oral melanoma is the most common maxillofacial malignancy in dogs. A unique characteristic of melanoma is its ability to mimic other oral tumors, which makes it one of the most challenging oral tumors to diagnose, especially since 30% to 40% of cases are amelanotic. This article presents 2 case reports of dogs with amelanotic oral melanoma that were both diagnostically challenging.
View Article and Find Full Text PDFEvaluating the Diagnostic Accuracy and Challenges of the Two-Week Wait Referral Pathway for Skin Cancers in Primary Care.
Cureus
January 2025
Consultation-Liaison Psychiatry, York and Scarborough Teaching Hospitals NHS Foundation Trust, York, GBR.
Skin cancers are among the most common cancers in the Western world, with incidence rates increasing significantly over time. Skin cancer survival rates are highly dependent upon early identification. In the United Kingdom (UK), initial assessment of skin lesions is carried out via general practitioners (GPs) who identify and refer suspected cases under the two-week pathway in compliance with the National Institute for Health and Care Excellence (NICE) guidelines.
View Article and Find Full Text PDF"Pathway Leap": A New Molecular Phenomenon to Consider in the Pathogenesis of Melanocytic Tumors.
Am J Dermatopathol
December 2024
Department of Cellular Pathology, Hospital El Bierzo, Ponferrada, Spain.
Introduction: The current WHO classification of melanocytic tumors distinguishes 9 pathogenic routes. This classification is based on the conceptual interpretation that melanocytic tumors evolve from benign counterparts, accumulating mutations, eventually developing into melanomas with metastatic and potentially lethal capacity. In this article, we present a molecular study of 2 melanocytic tumors that suggest a "leap" from pathogenic routes IV to I.
View Article and Find Full Text PDFIt Looks Like a Zebra but Is Not: [F]FDG PET/CT in a Giant Cutaneous Malignant Melanoma Mimicking Squamous Cell Carcinoma.
Diagnostics (Basel)
December 2024
Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, 00133 Rome, Italy.
Cutaneous malignant melanoma (MM) is the most aggressive form of skin cancer, associated with high mortality and rising incidence rates in Europe despite prevention efforts. Nodular MM, the most aggressive subtype, often mimics other skin tumors, complicating diagnosis. We present the case of a 66-year-old woman with a large, ulcerated tumor beneath the left scapula, along with multiple nodular lesions on the left arm and chest.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!