Reasons for excision of skin tumors: A one-year prospective study in a tertiary skin cancer unit

Background: Biopsies and surgical excisions represent routine procedures in clinical settings dealing with skin cancer. Objective: To evaluate the impact of clinical examination, dermoscopy, reflectance confocal microscopy and digital monitoring on the decision to excise or biopsy a lesion in routine practice. Methods: Patients scheduled for biopsy or excision of a skin lesion were prospectively enrolled. The expert dermatologist was asked to select the main factor that prompted him/her to excise or biopsy the lesion. Results: The most common reason for melanoma excision was clinical and dermoscopic morphology (70.3%), followed by dermoscopy (11.4%), monitoring (8.9%) and clinical context (8.2%). Most basal and squamous cell carcinomas were recognized both clinically and dermoscopically, while 18.6 and 15.0%, respectively, could only be detected with dermoscopic examination. Conclusion: Each part of the clinical examination has a contributory role in the diagnosis of melanoma and other skin cancers.