Time required for a complete skin examination with and without dermoscopy: a prospective, randomized multicenter study

Arch Dermatol. 2008 Apr;144(4):509-13. doi: 10.1001/archderm.144.4.509.

Abstract

Objective: To determine the time required to perform a complete skin examination (CSE) as a means of opportunistic screening for skin cancer both without and with dermoscopy.

Design: Randomized, prospective multicenter study.

Setting: Eight referral pigmented lesion clinics. Patients From June 2006 to January 2007, 1359 patients with at least 1 melanocytic or nonmelanocytic skin lesion were randomly selected to receive a CSE without dermoscopy or CSE with dermoscopy. For each patient, the total number of lesions and the duration of the CSE were recorded. A total of 1328 patients were eligible for analysis (31 were excluded because of missing data).

Main outcome measures: The median time (measured in seconds) needed for CSE with and without dermoscopy and according to total cutaneous lesion count.

Results: The median time needed for CSE without dermoscopy was 70 seconds and with dermoscopy was 142 seconds, a significant difference of 72 seconds (P < .001). The use of dermoscopy increased the duration of CSE, and this increase was in direct proportion to the patient's total lesion count. In contrast, the time required to perform a CSE without dermoscopy remained the same irrespective of whether the patients had few or many lesions.

Conclusions: A CSE aided by dermoscopy takes significantly longer than a CSE without dermoscopy. However, a thorough CSE, with or without dermoscopy, requires less than 3 minutes, which is a reasonable amount of added time to potentially prevent the morbidity and mortality associated with skin cancer.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Dermoscopy / statistics & numerical data*
  • Efficiency
  • Female
  • Humans
  • Male
  • Mass Screening / statistics & numerical data*
  • Melanoma / diagnosis*
  • Melanoma / pathology
  • Middle Aged
  • Neoplasms
  • Neoplasms, Multiple Primary / diagnosis
  • Neoplasms, Multiple Primary / pathology
  • Prospective Studies
  • Skin / pathology
  • Skin Neoplasms / diagnosis*
  • Skin Neoplasms / pathology
  • Time and Motion Studies*