BACKGROUND. Skin biopsy is an important part of dermatology practice. Little is known regarding dermatologist biopsying practices. OBJECTIVE. The objective was to assess the ratio of malignant lesions biopsied in practice and factors that influence this ratio. METHODS. Using a dermatopathology database, we analyzed tumors biopsied by dermatologists to determine the ratio of malignant to all tumors (malignancy ratio). Additional analyses were performed for factors influencing this ratio. RESULTS. Over 6 months, 11,072 tumors were submitted. Overall, the malignancy ratio was 41.7%, 3.8% for pigmented lesions. Practice type, location, or use of dermatoscopy did not influence this ratio; provider age was positively correlated with a higher malignancy ratio (r = 0.51; p = 0.02) and was a predictor of malignancy ratio (b = 0.02; p = 0.04). CONCLUSION. Approximately 40% of biopsied tumors were malignant. Dermatologists exhibit a wide range in their individual practice patterns. Increasing provider age predicted higher malignancy ratios with a 2% increase for each incremental year.
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