Table 1.

Suggested patient history.

History	Significance
How long has the lesion been present?	Newly acquired lesions that persist for longer than one or two months may indicate neoplasm, particularly if the patient is in an older age group
Has a pigmented lesion changed in color or shape?	Alteration in shape or color may point towards malignancy
Has there been any bleeding?	Some benign lesions bleed, e.g., pyogenic granuloma or seborrhoeic keratosis. Basal cell carcinomas may also bleed. In general, melanomas bleed only when well advanced, and in such cases the diagnosis is usually obvious
Does the lesion itch?	Benign naevi or irritated seborrhoeic keratosis may itch when irritated by clothing, etc. While early melanomas are usually asymptomatic, some melanoma may develop an abnormal sensation that patients often find difficult to accurately describe
Is there a history of occupational sun exposure, or has the patient lived or worked in the tropics?	Skin cancers in general are related to life-time sun exposure. Malignant melanomas may be related to a single severe episode of sunburn, particularly in childhood
Is there a family history of skin cancer?	This may indicate a genetic susceptibility, inherited skin type or condition such as dysplastic naevus syndrome