P096 Incidental detection of cutaneous malignancy during full-skin examination in a dermatology lesion clinic: a retrospective case review study

Abstract

Full-skin examination (FSE) is a core component of dermatological assessment, facilitating evaluation of the presenting lesion and detection of additional pathology. This retrospective case review study aimed to examine the yield of incidental malignant and carcinoma in situ lesions detected through FSE in a dermatology lesion clinic. 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. Of 479 patients assessed, 140 underwent further investigation of an index lesion, an incidental lesion or both. Fifty-six malignant and 14 carcinoma in situ index lesions were identified. FSE detected an additional 23 incidental malignant or carcinoma in situ lesions, including 18 histologically confirmed lesions (2 melanomas in situ, 2 squamous cell carcinomas, 12 basal cell carcinomas and 2 squamous cell carcinomas in situ) and 5 clinically diagnosed squamous cell carcinomas in situ. In 13 of 23 incidental lesions, the index lesion was benign; both incidental melanoma in situ cases occurred in this group. FSE resulted in a clinically meaningful number of detections of incidental malignant lesions and carcinomas in situ and remains a valuable component of comprehensive dermatological assessment in lesion clinics.