DERMATOLOGY COMMUNITY
Skin exam protocol

Skin exam protocol

Greetings: My mother had a melanoma, which was removed before it spread, so I like to have a skin screening twice a year. Normally the nurse instructs me to remove all clothes except my underwear and wear a gown. Hence they don't actually examine all areas of my body. I am much more preoccupied with thoroughness than modesty, but I feel awkward requesting that they be thorough. Shouldn't skin screenings be done fully nude? And shouldn't all areas, including crotch and genitalia be examined? Is it inappropriate to mention this??
Thanks
Avatar_m_tn
Hi Sotaylor.  Yes, the dermatologist should be checking all of your skin.  I found a video on the CBS medical site that covers this very topic:

http://www.cbsnews.com/video/watch/?id=4950095n

I have been doing research on this, since I have never had a skin cancer screening, and I wanted to know what to expect.  It would be reasonable for your to wear a gown, and possible even underwear.  But, at some point during the examination, these should be removed.

I completely understand your reservations, with regard to asking about this.  In fact, I had similar reservations about asking why my doctor does not perform certain tests.  That post is in the General Health section of this site, if you are curious as to the responses that I received:

http://www.medhelp.org/posts/General-Health/Is-my-doctor-avoiding-certain-tests--during-my-annual-physical-exam--to-spare-my-modesty/show/1485457.

The best advice that I can give, mirrors that which I was given:  No, it is not inappropriate to mention this.  I suggest that you simply ask your doctor if melanoma can form on any of your skin, even that which is normally covered by clothing.  Since we know that it can, then you could ask if he or she could check those areas, as well.  If the doctor refuses, then I think that you should find another.  

I know it is kind of uncomfortable to do this, because your doctor really should not need to be reminded to include all areas as part of the examination.  Also, you may even think it sounds like you are asking to take off your clothes, which feels strange.  But, all that you are really doing is ensuring that you get the care that you need, and your doctor should understand that.

Best of luck!

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