Incidental lesions found in veterans referred to dermatology: The value of a dermatologic examination

Incidence of melanoma and keratinocytic carcinomas in patients evaluated by store‐and‐forward teledermatology vs. dermatology clinic

“…However, this difference was not statistically significant, and a larger sample size would be beneficial in clarifying the significance of this trend. The observed keratinocytic carcinoma detection rates for SAF teledermatology and F2F consultation in this study (5.5% and 8.5%, respectively) are comparable to prior studies in the VA and general population …”

“…In most of these cases, the lesions for which the patients were initially referred turned out to be benign . In a separate study of over 17,000 dermatology consults within the VA Healthcare system, 6.9% of patients had incidental skin cancers, and 0.05% had incidental melanomas . The incidence of detected skin cancers via face‐to‐face consultation (F2F) may potentially be higher than that of SAF teledermatology.…”

Unimaged Melanomas in Store-and-Forward Teledermatology

“…Prior studies have shown that dermatologist discovered melanomas were thinner melanomas, while more invasive melanomas are found by the PCP. 14 We ascertained the time interval between the biopsy and the previous SFT visit. This ranged from as few as 21 days to as many as 930 days ( Table 1).…”

“…[7][8][9][10][11] This concern is more related to the perceived inability of primary care providers (PCPs) to direct imaging of suspicious lesions than to the SFT dermatologist's ability to diagnose them. [12][13][14] At least three previous studies have ascertained the frequency of ''incidental'' melanomas in populations of patients referred for FTF dermatology care. An incidental melanoma is defined as a melanoma discovered by a dermatologist during full body skin examination (FBSE), but was not the subject of the referral.…”

“…14 Based on these studies, there is justifiable concern that unimaged melanomas may be present in patients being referred to SFT for other dermatologic concerns. 1,[12][13][14][15] We conducted this quality improvement study to ascertain the frequency at which unimaged melanomas occurred among patients enrolled in a VA SFT program and to determine what, if any, policy and procedural changes might be necessary to improve the program.…”