British Journal of Anaesthesia (BJA)
05/03/2002
By David Loshak
Self-assessment of melanoma risk based on the presence of multiple naevi is not reliable but, to prevent pigmented lesion clinics from becoming overworked, only people with a specific suspicious lesion should be referred.
This means that the filtering role of the family doctor needs to improve, say dermatologists and other specialists in Florence, Italy.
The specialists noted that early diagnosis of melanoma is based on co-operation between dermatologists and family doctors. But, wide publicity about the risks of excessive exposure to the sun had led many people to worry more about changing moles. The workload of pigmented lesion clinics had steadily risen in consequence.
The specialists investigated the reasons for referral of 193 consecutive patients at a pigmented lesion clinic. Because the number of naevi is the major risk factor for melanoma in Mediterranean populations, and to classify those at high risk, the specialists also looked at the extent to which self-counting of naevi agreed with a dermatologist's evaluation.
Clinically suspicious lesions at dermatological examination were found in 13 (6.7 percent) referred by general practitioners (6.7 percent). Three melanomas were histologically confirmed.
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