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Aust J Gen Pract. 2019 Jun;48(6):357-362.

Improving diagnostic accuracy for suspicious melanocytic skin lesions: New Australian melanoma clinical practice guidelines stress the importance of clinician/pathologist communication.

Author information

1
MD, Conjoint Medical Director, Melanoma Institute Australia, University of Sydney, Sydney, NSW; Clinical Professor, Discipline of Pathology, Faculty of Medicine and Health, University of Sydney, Sydney, NSW; Senior Staff Specialist in Anatomical Pathology, Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, NSW.
2
MD, Chair of Dermatology, University of Queensland, Brisbane, Qld; Director of the Dermatology Department, Princess Alexandra Hospital, Brisbane, Qld; Director of the Dermatology Research Centre, UQ Diamantina Institute, University of Queensland Faculty of Medicine, Brisbane, Qld.
3
Head, Victorian Melanoma Service, Alfred Hospital, Melbourne, Vic.
4
MBBS, Pathologist, Clinpath Laboratories, Kent Town, Adelaide, SA.
5
MBBS, Professor and Head of Department of Anatomical Pathology, Alfred Hospital and Victorian Melanoma Service, Melbourne, Vic.
6
PhD, Associate Professor, University of Adelaide, Adelaide, SA; Research Director of the Australian Melanoma Research Foundation, Adelaide, SA; Surgeon, Royal Adelaide Hospital, Adelaide, SA.
7
PhD, Staff Specialist in Anatomical Pathology, Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, NSW; Pathologist, Melanoma Institute Australia, Sydney, NSW.
8
MBBS (Hons), FRCPA, Staff Specialist in Anatomical Pathology, Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, NSW; Pathologist, Melanoma Institute Australia, Sydney NSW.
9
PhD, Director, Victorian Melanoma Service, Alfred Hospital, Melbourne, Vic; Adjunct Associate Professor, School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic.
10
MBBS, Research Fellow, Victorian Melanoma Service, Alfred Hospital, Melbourne, Vic.
11
MMed(Skin Cancer), Senior Lecturer, Skin Cancer Unit, Faculty of Medicine, University of Queensland, Brisbane, Qld; General Practitioner, Norwest Skin Cancer Centre, Bella Vista, NSW.
12
DPhil(Oxon), Deputy Director, Melanoma Institute Australia, University of Sydney, Sydney, NSW; Associate Professor of Melanoma and Skin Oncology, University of Sydney, Sydney, NSW; Senior Plastic Surgeon, Melanoma Institute Australia, Sydney, NSW.
13
MBBS (Hons I), DDM, FACD, FAMA, Clinical Professor in Dermatology, University of Sydney, Sydney, NSW; Dermatologist, Royal Prince Alfred Hospital, Sydney, NSW.
14
MD, Chairman, Australian Melanoma Clinical Practice Guidelines Working Party; Professor of Melanoma and Surgical Oncology, University of Sydney, Sydney, NSW; Surgeon, Royal Prince Alfred Hospital and Melanoma Institute Australia, Sydney, NSW.

Abstract

BACKGROUND:

Incorrect or delayed diagnosis of melanoma may lead to inappropriate treatment, poor clinical outcomes, increased cost and medicolegal consequences. The provision of pertinent clinical information is essential for accurate pathological diagnosis of cutaneous melanocytic tumours. Failure to provide this information may contribute to poor outcomes.

OBJECTIVE:

The aim of this article is to highlight important clinical information that clinicians can provide to pathologists to facilitate accurate diagnosis of melanocytic tumours.

DISCUSSION:

Pertinent clinical information includes patient age, sex, tumour site, specimen orientation (if appropriate), history of the lesion, presence of any clinically or dermoscopically suspicious areas within the lesion (including apparent regression), access to any relevant clinical and/or dermoscopic photographs and prior pathology reports, melanoma history and risk factors, and history of concurrent or recent pregnancy. If the clinical features are not concordant with the pathology findings, the clinician and pathologist should discuss the case to identify the reason for incongruence.

PMID:
31220881
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