Fatimah Ghalib Mahdi Al-Najjar (1)
This clinical trial provides the first institutional evaluation of benign and malignant cutaneous mole excisions in Iraq. The study demonstrates that, even in a resource-limited setting, combining clinical examination with dermoscopy and histopathology yields high diagnostic accuracy (89.4%), with sensitivity 85.7% and specificity 97.1%. Most false-negative cases were related to subtle pigment changes in darker skin types, underscoring the need for low thresholds for excision of evolving lesions. Facial lesions were common (41.3%) due to cosmetic concerns and high UV exposure. The relatively young median age (34.2 years) suggests possible early UV exposure or delayed healthcare access. Surgical outcomes were favorable, with a low complication rate (5.6%) and no recurrence of benign nevi at 12 months. Limitations of Iraq’s healthcare system—such as limited dermatopathology capacity, slow biopsy turnaround, and absence of a national skin cancer registry—affect long-term care and surveillance. Despite these constraints, results show that effective and safe mole management is achievable. The study supports implementing dermoscopy training, standardized excision protocols, public education on the ABCDE criteria, and improved pathology referral networks to strengthen national skin cancer care.
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