Incidental Detection of Cutaneous Malignancy During Full Skin Examination in a Dermatology Lesion Clinic: A Retrospective Case Review Study
Stephanie‐Lynn Ryan, Louise Fleming, Rachel Kelly, Sarah McKenna, Ali AlsharqiABSTRACT
Background
Full skin examination (FSE) is a core component of dermatologic assessment, facilitating evaluation of the presenting lesion and detection of additional pathology.
Objectives
This retrospective case review study examined the yield of incidental malignant lesions detected through FSE in a dermatology lesion clinic.
Methods
Clinic correspondence and histopathology were reviewed for 479 new patients assessed in a university‐affiliated dermatology clinic between January and June 2024. All patients were offered FSE. Outcomes of index and incidental lesions were recorded and analysed descriptively.
Results
Of 479 patients assessed, 140 underwent further investigation of an index lesion, an incidental lesion, or both. Seventy malignant index lesions were identified. Of 462 patients who underwent full skin examination, 19 patients (4.1%) had at least one incidental malignant lesion detected. A total of 21 incidental malignant lesions were identified, including 16 histologically confirmed lesions (two melanoma in situ, two squamous cell carcinomas, 10 basal cell carcinomas, and two squamous cell carcinomas in situ) and five clinically diagnosed squamous cell carcinomas in situ. In 13 of 21 incidental lesions, the index lesion was benign; both incidental melanoma in situ cases occurred in this group.
Limitations
This study is limited by its retrospective design and reliance on clinic documentation, with some incidental carcinoma in situ diagnoses based on clinical assessment rather than histopathology.
Conclusions
Full skin examination resulted in a clinically meaningful number of incidental malignant detections and remains a valuable component of comprehensive dermatologic assessment in lesion clinics.