Melanoma on the foot

[jman23]

Question to you pods and residents -

Is it within the normal scope for a podiatry in private practice to excise melanoma found on the foot or is that usually referred out to a derm?

Thanks in advance!

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[Feli]

It could be excised by pod surg, derm, or surg onco... probably even gen surg in some rural areas.

It's a personal judgement call, but with a biopsy confirmed cutaneous melanoma (and assuming no evidence of mets), I'd probably recommend wide excis and then send the pt for (prompt) derm second opinion to CYA. Any derm worth their salt would bill the clin consult, make their honest rec in a report back to you, and send the pt back to your office for the lesional excision. Yes, some less ethical ones might "steal the patient," and in that case, you learn who to never refer to again. JMO

 

[NatCh]

A patient of mine had one last year. I did a wide excision sent to Pathology (of course) for confirmation, then called an Oncologist who said he didn't need to see the patient (documented).