How informative are dermatopathology requisition forms completed by dermatologists? A review of the clinical information provided for 100 consecutive melanocytic lesions.

Background: Accurate clinicopathologic correlation can be crucial to arriving at the correct microscopic diagnosis. Objective: We reviewed the clinical information provided on the dermatopathology requisition forms for melanocytic lesions submitted by community dermatologists. Methods: The clinical information provided and the microscopic diagnoses rendered were recorded in a retrospective, unblinded fashion for 100 consecutive melanocytic lesions submitted as wet tissue to our dermatopathology department. Results: Biopsy specimens were received from 60 community dermatologists and 5 nurse practitioners/physician assistants. Clinical morphology (ie, papule) was provided in 33% of cases. With respect to the ABCDE criteria, 55% of cases had none, 12% had one criterion, 21% had two criteria, 10% had 3 criteria, 2% had 4 criteria, and none had all 5 criteria. No forms stated whether the biopsy specimen was a partial or complete sampling of the lesion. Asymmetry was provided 4% of the time, border irregularity 8%, color 39%, diameter 22%, and evolution 10%. A family or personal history of melanoma was provided in 8% of cases. No requisition forms mentioned the “ugly duckling” sign. Dermatoscopy information and a clinical photograph were provided once each. In 19 cases, the only information on the requisition form was one of the phrases: “r/o atypia,” “r/o atypical nevus,” “r/o Clark''s,” or “r/o dysplastic nevus.” In 10 cases, the only information was “r/o nevus.” Limitations: Only 100 consecutive melanocytic lesions were studied in a retrospective, unblinded fashion. Conclusion: Important clinical information regarding pigmented lesions is often not provided on the requisition form. Potential reasons for this deficit and suggestions for improvement are discussed. [Copyright &y& Elsevier]