TY - JOUR
T1 - Nondermatologists' use of predictive terms for a potentially malignant lesion
AU - Tolpinrud, Whitney L.
AU - Viola, Kate V.
AU - Kirsner, Robert Scott
AU - Gross, Cary P.
AU - Imaeda, Suguru
AU - Federman, Daniel G.
PY - 2011/7/1
Y1 - 2011/7/1
N2 - Background: Skin cancer is frequently suspected by nondermatologists. Many dermatology practices currently do not triage referrals from nondermatologists. Little is known how nondermatologists describe lesions of concern when making referrals. Objective: We sought to assess the descriptive terminology used by nondermatologists when referring patients with potential cutaneous malignancies. Methods: We completed a retrospective chart review of 400 patients referred by nondermatologists for skin lesions suspicious of malignancy. We collected the reason for the consult, all terminology used to characterize the lesion, and the final diagnosis. Results: Clinicians documented 680 reasons for referring patients with suspicious lesions. General concern (rule out malignancy) without specific descriptors was used in 78 referrals, of which 23% (n = 18) were found to be associated with malignancy. Specific descriptive terminologies used most frequently by nondermatologists to describe suspicious lesions were: hyperpigmented (n = 71), changing size (n = 69), nonhealing (n = 55), irregular border (n = 52), irritated and/or scaly (n = 40), and raised (n = 33). A statistically significant correlation (P < 0.05) was found between skin cancer and the following terms: nonhealing, ulcerated, and rule out basal cell carcinoma. Conclusion: The descriptive terminology of potential cutaneous malignancies utilized by nondermatologists may provide important clues to aid dermatologists in triage decisions. Specifically, ulcerated, nonhealing, and rule out basal cell carcinoma may be terms that indicate the patient should be seen by the dermatologist in a timely manner.
AB - Background: Skin cancer is frequently suspected by nondermatologists. Many dermatology practices currently do not triage referrals from nondermatologists. Little is known how nondermatologists describe lesions of concern when making referrals. Objective: We sought to assess the descriptive terminology used by nondermatologists when referring patients with potential cutaneous malignancies. Methods: We completed a retrospective chart review of 400 patients referred by nondermatologists for skin lesions suspicious of malignancy. We collected the reason for the consult, all terminology used to characterize the lesion, and the final diagnosis. Results: Clinicians documented 680 reasons for referring patients with suspicious lesions. General concern (rule out malignancy) without specific descriptors was used in 78 referrals, of which 23% (n = 18) were found to be associated with malignancy. Specific descriptive terminologies used most frequently by nondermatologists to describe suspicious lesions were: hyperpigmented (n = 71), changing size (n = 69), nonhealing (n = 55), irregular border (n = 52), irritated and/or scaly (n = 40), and raised (n = 33). A statistically significant correlation (P < 0.05) was found between skin cancer and the following terms: nonhealing, ulcerated, and rule out basal cell carcinoma. Conclusion: The descriptive terminology of potential cutaneous malignancies utilized by nondermatologists may provide important clues to aid dermatologists in triage decisions. Specifically, ulcerated, nonhealing, and rule out basal cell carcinoma may be terms that indicate the patient should be seen by the dermatologist in a timely manner.
KW - Basal cell carcinoma
KW - primary care
KW - screening
KW - skin cancer
KW - squamous cell carcinoma
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U2 - 10.1097/SMJ.0b013e31821f8c2c
DO - 10.1097/SMJ.0b013e31821f8c2c
M3 - Article
C2 - 21886045
AN - SCOPUS:79959671084
VL - 104
SP - 477
EP - 481
JO - Southern Medical Journal
JF - Southern Medical Journal
SN - 0038-4348
IS - 7
ER -