Evaluation of prospectively collected presenting signs/symptoms of biopsy-proven melanoma, basal cell carcinoma, squamous cell carcinoma, and seborrheic keratosis in an elderly male population - 12/08/11

Doi : 10.1016/j.jaad.2006.11.032

Sharone K. Askari, MD ^a,^b, Sarah E. Schram, MD ^a, Rachel A. Wenner, MD ^a,^c, Sacharitha Bowers, MD ^a,^d, An Liu, MS ^a, Ann K. Bangerter, BS ^a, Erin M. Warshaw, MD, MS ^a,^c,^⁎
^a From the Departments of Dermatology at Minneapolis Veterans Affairs Medical Center
^b St Louis University
^c University of Minnesota, School of Medicine
^d Department of Dermatology, Southern Illinois University, Springfield

Correspondence to: Erin M. Warshaw, MD, MS, Dermatology Department 111K, Veterans Affairs Medical Center, One Veterans Dr, Minneapolis, MN 55417.

Minneapolis, Minnesota; St Louis, Missouri; and Springfield, Illinois

Abstract

Background

Presenting signs/symptoms of skin cancer may aid in earlier detection and diagnosis.

Objective

We sought to compare prospectively collected, presenting signs/symptoms of malignant melanoma (MM), basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and seborrheic keratosis (SK).

Methods

This analysis was part of a larger study on teledermatology involving 3039 skin neoplasms in 2152 patients at a Department of Veterans Affairs medical center. At presentation, participants were asked about signs/symptoms of specific skin lesions. In all, 912 biopsy-proven MM (39), BCC (411), SCC (238), and SK (224) were included in this analysis. Pearson χ² analyses were used to test associations of lesion type and specific signs/symptoms in pairwise comparisons.

Results

“No symptoms” was reported more often with MM (82%) as compared with BCC (relative risk [RR] 2.26, confidence interval [CI] 1.86, 2.75), SCC (RR 3.31, CI 2.54, 4.32), or SK (RR 2.0, CI 1.61, 2.48; all P < .0001). Tenderness was more commonly reported with SCC (40%) as compared with MM (RR 15.9, CI 2.28, 110.69), SK (RR 3.0, CI 2.11, 4.39), or BCC (RR 2.6, CI 1.97, 3.38; all P < .0001). Bleeding was more commonly reported with BCC (37%) as compared with SK (RR 2.3, CI 1.67, 3.20), SCC (RR 1.6, CI 1.22, 2.05), or MM (RR 29.8, CI 1.89, 469.65; all P ≤ .007).

Limitations

The small number of MM and study population characteristics (elderly, Caucasian, male) limit generalizability.

Conclusion

This study describes common signs/symptoms of BCC, SCC, and SK. Our findings suggest that MM may be asymptomatic more often than previously recognized.

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Abbreviations used : BCC, CI, MM, RR, SCC, SK, VA

Plan

SCC, BCC, and SK symptoms

Association of melanoma depth with other factors

Association of MM, BCC, SCC, and SK signs/symptoms with other factors

Symptoms of SCC in patients with transplantation versus nontransplantation

Discussion

Conclusion

Supported, in part, by Department of Veterans Affairs Health Services Research and Development IIR 01-072-2 and the Minneapolis Health Services Research and Development Center of Excellence for Chronic Disease Outcomes Research.
Conflicts of interest: None declared.
Presented as an abstract in oral and poster form at the Society for Investigative Dermatology 67th Annual Meeting, Philadelphia, Pennsylvania, May 3 to 6, 2006.
The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs.
Reprints not available from the authors.