December 15, 2008

Seventy Seconds Inadequate for a Complete Skin Examination

Author Affiliations

Copyright 2008 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2008

Arch Dermatol. 2008;144(12):1658-1659. doi:10.1001/archdermatol.2008.501

We read with skepticism “Time Required for a Complete Skin Examination With and Without Dermoscopy” by Zalaudek et al1 and believe that the time required for a complete skin examination was grossly understated. A complete skin examination includes the evaluation of the scalp, genitalia, mucous membranes, and conjunctiva. In this study, the scalp and genitalia were not examined unless directed by the patient. We suspect that these areas were examined infrequently, since it is unusual for a woman to point out a pigmented vulvar lesion, and macular lesions on the scalp are usually invisible to the patient. The scalp examination is usually the most time-consuming part of a complete skin examination. Moreover, there was no mention whether mucous membranes or conjunctiva were included in the examination described in the study. Perhaps the title of the article would have more accurate as “Time Required for a Partial Skin Examination. . . .”

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