Yield from total skin examination and effectiveness of skin cancer awareness program. Findings in 874 new dermatology patients.

The authors reviewed 874 dermatology charts to assess the acceptance rate of total skin examination (TSE), incidental skin findings, and patient compliance regarding treatment recommendations. Of the 874 new dermatology patients studied, 707 (80.9%) agreed to TSE. Important incidental findings were found in 151 (21.4%). These included: (1) biopsy specimen-confirmed malignant tumors (malignant melanoma, lentigo maligna, and basal cell and squamous cell carcinoma) in 24 of the 707 patients (3.4%), (2) biopsy specimen-confirmed premalignant tumors (actinic keratosis with dysplasia, Bowenoid actinic keratosis, Bowenoid papulosis, and lentigo with dysplasia, in five (0.7%), (3) clinically diagnosed premalignant actinic keratosis in 64 (9.1%), (4) biopsy specimen-confirmed dysplastic nevi in 17 (2.4%), and (5) congenital nevi in 41 (5.8%). Only 4.2% of the patients returned for a yearly TSE, and only 6.0% were found to follow all recommendations for monthly self examination, yearly professional examination, and sun protection. It is concluded that TSE for all new patients, and on a yearly basis for all return patients, is valuable in the detection of many skin conditions and allows skin cancer screening to be done, since patients for the most part do not follow recommendations for at-home screening.