Dermatological surgery: a comparison of activity and outcomes in primary and secondary care

Summary Background Dermatological surgery is carried out by a variety of practitioners in primary and secondary care. Objectives To explore the activity and histopathological outcomes among different groups of dermatological surgeons dealing with skin cancers. Methods Reports for all new skin tumour specimens processed by our histopathology department over a continuous 3‐month period were reviewed retrospectively. Results One thousand, one hundred and eleven new skin tumour specimens were identified. General practitioners (GPs) were least accurate in clinical diagnosis, with 42·8% (59/138) of their request forms including the eventual histological diagnosis, compared with 69·5% (328/472) for dermatologists (odds ratio, OR 0·33, 95% confidence interval, CI 0·22–0·48). Inappropriate procedures were most often performed by plastic surgeons, usually involving large excision biopsies for benign lesions in elderly patients [6·6% (20/305) of their specimens vs. 0% for dermatologists, exact P