Dermatology Experts Discuss Inadequate Testing of Skin Lesion

ByJoseph O'Neill

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Updated onOctober 5, 2017

Dermatology Experts Discuss Inadequate Testing of Skin Lesion

This case involves a male patient who had been under the care of a dermatologist for several years in order to monitor a number of pre-cancerous moles on his back. During this time, the patient developed a new mole on his nose that changed character over the years that the man was seen by the dermatologist. At some point, the doctor claims to have taken a skin shave biopsy of the suspected lesion which turned up negative. A year later, the man saw a new dermatologist on the recommendation of his primary care provider. This doctor diagnosed the lesion as cancerous, and subsequent testing revealed a number of metastases.

Question(s) For Expert Witness

1. When is shave biopsy recommended for a lesion?

2. When is a punch biopsy indicated?

Expert Witness Response E-060295

inline imageA shave biopsy should have been entertained as soon as the lesion changed or when the patient said that lesion was changing. a shave biopsy would have likely ascertained the diagnosis, though it is unclear why it may not have in this instance. A punch biopsy on the nose can be cosmetically difficult, so generally in my opinion only if I am worried about a deep lesion or if a shave biopsy does not give a diagnosis would I recommend the more invasive punch biopsy.

About the author

Joseph O'Neill

Joseph O'Neill

Joe has extensive experience in online journalism and technical writing across a range of legal topics, including personal injury, meidcal malpractice, mass torts, consumer litigation, commercial litigation, and more. Joe spent close to six years working at Expert Institute, finishing up his role here as Director of Marketing. He has considerable knowledge across an array of legal topics pertaining to expert witnesses. Currently, Joe servces as Owner and Demand Generation Consultant at LightSail Consulting.

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