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GIORNALE ITALIANO DI DERMATOLOGIA E VENEREOLOGIA

A Journal on Dermatology and Sexually Transmitted Diseases


Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
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Giornale Italiano di Dermatologia e Venereologia 1998 December;133(6):405-10

language: Italian

Campaign for early detection of melanoma: how well do general physicians recognize suspicious pigmented lesions?

Carli P. 1, Nardini P. 1, Moretti S. 2, De Giorgi V. 1, Mannone F. 1, Donati E. 1

1 Università degli Studi - Firenze, I Clinica Dermatologica;
2 Università degli Studi - Firenze, II Clinica Dermatologica


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Background. Due to facilities of the National Health Service, screening campaigns for melanoma carried out in Italy involved general physicians (GP) for a screening procedure to select suspicious pigmented lesions to be submitted to dermatological examination. The aim of this strategy is to avoid the workload related to the open access of public to pigmented lesion clinic. However, some concerns do exist about the ability of non dermatologists to perform a screening procedure for skin tumours.
Objective. The aim of this study is to assess the characteristics of pigmented lesions selected by physicians to be submitted to dermatology services.
Setting. A series of 262 subjets consecutively observed in two months at the PLC of the Department of Dermatology in Florence.
Methods. Clinical features of lesions cause of referral to PLC were evaluated.
Results. Only 37% of lesions were correctly defined as suspicious by GP because their clinical atypia (melanoma and atypical nevi, non melanoma skin cancers, clinically equivocal lesions). In the other cases, the subjects presented benign pigmented lesions, both of melanocytic (common nevi, blue nevi) or non melanocytic origin (seborrheic keratosis, dermatofibromas, angiokeratoma) with typical clinical features, whose diagnosis should be considered easy to perform by GP.
Conclusions. In melanoma screening activity, the selection by GP of suspicious pigmented lesions to be submitted to dermatology services is commonly associated with a high percentage of false positive findings. More extensive training of GPs in the field of clinical diagnosis of pigmented skin lesions should be achieved.

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