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

Sharone K. Askari, Sarah E. Schram, Rachel A. Wenner, Sacharitha Bowers, An Liu, AnnMarie K Bangerter, Erin M Warshaw

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29 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)739-747
Number of pages9
JournalJournal of the American Academy of Dermatology
Volume56
Issue number5
DOIs
StatePublished - May 2007

Bibliographical note

Funding Information:
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.

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