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Old 08-05-2016, 12:59 PM
 
Location: San Diego, CA
104 posts, read 227,334 times
Reputation: 190

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About a week ago I noticed a small, flaky blemish on my shin that bled a bit after I picked at it. I had been meaning to finally get a full-body skin exam for a while now so this finding encouraged me to make an appointment. I've never had a full-body skin exam and I am quite fair with non-melanoma skin cancer in my maternal family line but I myself have never had skin cancer, nor have I had a lot of excessive sun exposure my life (I'm a 32 year old male), nor do I have a lot of moles or skin irregularities (but I do have some freckles).

I had the exam with my new dermatologist this morning (of the in-network derms, this office had the best Yelp reviews). They had me undress, put on a gown, but told me to leave my underwear on. The doctor then enters and asks me a bit about why I'm there and I tell him about the shin blemish and wanting a full body check anyway. He briefly looks at the shin and tells me it's probably a seborrheic keratosis and nothing to be concerned about but that they could freeze it off if it bothered me; I declined since it wasn't a concern. Then he briefly glanced over my scalp/hairline, legs, back, chest, arms, abdomen, and asked me if any other areas were of a concern to me and I said no. He said that some people have a lot of irregular moles but he didn't see any on me. He then asked if anything in my groin/buttocks area was of concern and I said no. The entire "exam" lasted about 60 seconds.

The thing is, I thought he would go through my entire body more carefully and palpably and possibly even use a black light or magnifying lens. I've done a bit of reading on what a thorough skin exam should entail and almost every site mentions the dermatologist carefully looking over the skin with palpation and even a black light or some sort of magnifier. While I do lack many moles, I am fair with some freckles and he didn't inspect those areas thoroughly at all. I replied 'no' to him asking me about any other areas of concern because there wasn't anything else besides the blemish on my shin that stood out to me. Looking back i think it should have been his job to notice things that aren't easily apparent to the lay-person or may be out of sight when looking at oneself in the mirror.

My question is, should I find a more thorough dermatologist or is this type of full-body skin exam standard? I feel that if what I'm looking for is something thorough it should have lasted more than 60 seconds and the doctor should know that the patient doesn't always know if something is of concern or not.
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Old 08-05-2016, 02:13 PM
 
Location: OH>IL>CO>CT
4,747 posts, read 7,491,873 times
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At about age 60, when I first started seeing a GP regularly, he diagnosed my many existing "spots" as seborrheic keratosis. SKs are a very common benign skin condition. We also watched some new spots come and go on their own. After about 3 years, I too decided to see a well-regarded dermatologist, just in case. He too did what seemed like a cursory exam, and saw no problems.

Three years later, having moved out of state, I noticed a new unusual spot on my foot. Got a appt. with a local dermo. He is attached to a teaching hospital, so I was first seen by an intern, who said the spot may be something to check further, so when the dermo came in, he looked at it, and said yes it needed a biopsy.

The biopsy confirmed a squamous cell cancer, stage 1 in situ. Meaning it had not spread. It was later removed using the MOHS procedure.

I have since had 4 annual full body exams. Each time with the same dermo, but a new intern. Each time it does seem like the exam is pretty cursory, but when I ask about any spots that are not SKs, they always tell me what it is. (and that it is benign.)

So my estimation is if your dermo has many years of experience looking at people's spots, they get to where they recognize any issues pretty easily.

So still do your own self exams, and don't be afraid to ask questions.
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Old 08-08-2016, 07:22 PM
 
Location: Fredericksburg, Va
5,119 posts, read 12,713,147 times
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If there is a particular "spot" that you think needs more examination...tell them! Otherwise, a dermatologist can tell, pretty much, at first glance if something warrants more attention.
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Old 08-08-2016, 09:24 PM
 
Location: Out there somewhere...
38,673 posts, read 45,016,991 times
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OP, your exam sounds normal to me. As others are telling you the doctor's know what they are doing, looking for, and can spot something that needs attention immediately. My dermatologists does a full body exam twice a year and it doesn't take long unless she finds something unusual. Then we discuss what needs to be done.
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Old 08-10-2016, 05:37 PM
 
2,746 posts, read 3,914,197 times
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I recently had my first ever skin check & it was much quicker than I anticipated.

I asked the doctor, and she said that dermatologists know exactly what to look for and can spot anything abnormal right away.

Probably a good idea to have a skin check every year, especially if there's a history of skin problems in the family.
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Old 03-20-2017, 02:47 PM
 
1 posts, read 1,265 times
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I had my first skin exam at 50 after my first physical at age 50 after my primary questioned spots on my back. I went to a large derm practice and selected a derm that was well regarded and was associated with the local university medical program as a professor of dermatology. I have a family history of skin cancer, including melanoma, and I am light skinned, blue eyed, blonde haired, and had many blistered sun burns as a youth.

I had specific spots that I questioned so when the dorm stepped into the room and asked I pointed out the areas of concern. A specific spot was on my wrist. She stated that everything was benign and was in and out of the room in under 3 minutes. I felt it was a cursory exam and after leaving I scheduled another exam at a smaller practice and was given an appt. with the PA. She was great and took the time to check every bit of skin on me and was open to questions and gave me detailed answers that helped me understand what to look for.
I
She took a biopsy of the spot on my wrist and it turned out to be squamous cell. I have since had more squamous cell and basal cell cancers removed including one in my genital area. The first derm didn't bother checking. Fortunately no melanomas yet.

My opinion is that if you feel rushed or the exam was incomplete (to your standards not theirs) find one that will make you comfortable. The Experience of the doctor does not always indicate a "good" doctor.
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Old 03-20-2017, 02:52 PM
 
Location: Central IL
13,344 posts, read 7,115,490 times
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My exams have been very fast - I can't remember that magnification was ever used even though I have had several basal cell carcinomas found and biopsied/removed.

I tell her areas of concern but her actual check is fast. The light in the office is exceedingly bright so much so that I see every red mark! So between that and her experienced eye I feel safe.
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Old 03-20-2017, 03:10 PM
 
Location: ☀️ SWFL ⛱ 🌴
2,098 posts, read 1,420,653 times
Reputation: 7492
I have two areas of concern and was referred to a dermatologist who told me he could just look at those two spots but recommended a full body check. The exam was throrough, with him looking between my toes and through my hair, like monkeys do to each other, and it was hard not to laugh at that. He was using a lighted magnifier.

If you felt like it wasn't a thorough exam or are worried about it, get a second opinion or schedule with another dermatologist next time, asking exactly what a full body exam entails and how long it takes before scheduling.

Last edited by jean_ji; 03-20-2017 at 03:22 PM..
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Old 03-20-2017, 04:45 PM
Status: "I had a handle on life, but it broke" (set 10 days ago)
 
1,322 posts, read 2,053,786 times
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This is an old thread, but I'm glad that Blaster9223 revived it, as the subject is important.

I had annual exams at the VA, which consisted of the doctor racing into the room, telling me how behind she was, and then performing a perfunctory examination. On one occasion, the intern observing her questioned why some AKs on my head weren't treated, and the doctor responded, "You could spend hours treating every one of these, so just treat the major ones."

One day I received a letter from the VA, stating that I would now be treated at a local, non-VA, clinic, since it was closer to my home. There, the doctor used a dermatoscope, and an assistant recorded the results of the full-body examination, which included taking photographs. He explained what he was doing, and why. He performed cryosurgery, sent several tissue samples to the lab, and put me on a semi-annual schedule.

I jokingly asked him why he had to check where the sun don't shine (which he does annually with every patient), and he said that he had lost a patient because her original doctor failed to notice that she had anal cancer. It had metastasized and there was nothing he could do to save her.
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Old 03-22-2017, 05:30 AM
 
2,427 posts, read 783,770 times
Reputation: 3114
Quote:
Originally Posted by JustPassinThru View Post
This is an old thread, but I'm glad that Blaster9223 revived it, as the subject is important.

I had annual exams at the VA, which consisted of the doctor racing into the room, telling me how behind she was, and then performing a perfunctory examination. On one occasion, the intern observing her questioned why some AKs on my head weren't treated, and the doctor responded, "You could spend hours treating every one of these, so just treat the major ones."

One day I received a letter from the VA, stating that I would now be treated at a local, non-VA, clinic, since it was closer to my home. There, the doctor used a dermatoscope, and an assistant recorded the results of the full-body examination, which included taking photographs. He explained what he was doing, and why. He performed cryosurgery, sent several tissue samples to the lab, and put me on a semi-annual schedule.

I jokingly asked him why he had to check where the sun don't shine (which he does annually with every patient), and he said that he had lost a patient because her original doctor failed to notice that she had anal cancer. It had metastasized and there was nothing he could do to save her.
Exactly. Unless the doctor examines all of the skin they are not being thorough. What is the point of spending the time and money to go if they just assume there isn't a problem rather than determining there isn't a problem?

I went to a dermatology office last year and saw the NP for a myxoid cyst on a finger. I saw that the only male in this large office was the dermatologist himself and so asked the NP whether the doctor did full body exams by himself or if he brought one of the women in with him. She told me that I could request no female staff be present if I wanted, but that the doctor doesn't check the genital area unless I indicate there is a problem. Based on that I decided that if I do feel the need for a skin exam that I won't go to him as he is clearly not very thorough.
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