Bare necessities? The utility of full skin examination in the COVID19 era.

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Full skin examination (FSE) may improve the detection of malignant melanoma (MM). The objective of this study was to assess the safety of targeted lesion examination (TLE) compared to FSE in our pigmented lesion clinic (PLC). Patients attending PLC were randomised in a 2:1 ratio to FSE (intervention) or TLE (standard care). Demographic details and risk factors were documented. FSE and TLE were timed. Of 763 participants, 520 were assigned to FSE and 243 were assigned to TLE. On average, FSE took 4.02 minutes and TLE took 30 seconds. Thirty-seven (7.1%) patients had incidental findings on FSE. Twelve patients (2.3%) had additional lesions biopsied. No additional melanomas were detected that would have been missed by use of the standard protocol. This study suggests that in low-risk patients attending a PLC referred with a lesion of concern, the possibility of missing incidental cutaneous malignancies using lesion-directed examination is low.

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Authors: C O’Connor, C Gallagher, M O’Connell, J Bourke, M Murphy, M Bennett