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CASTLE BIOSCIENCES Castle Biosciences Announces First Quarter 2021 Results May 10 , 2021 Q1 2021 revenues of $ 22.8 million , compared to $ 17.4 million in Q1 2020 Q1 2021 total dermatology test report volume of 4,805 Initiates 2021 Revenue Guidance of $ 80-83 million Q1 2021 gross margin of 87 % Conference call and webcast today at 4:30 p.m. ET FRIENDSWOOD , Texas -- ( BUSINESS WIRE ) -- May 10 , 2021-- Castle Biosciences , Inc. ( Nasdaq : CSTL ) , a dermatologic diagnostics company providing personalized genomic information to improve treatment decisions , today announced its financial results for the first quarter ended March 31 , 2021 . " We are pleased with our strong execution in the first quarter , with revenue increasing by 31 % over the first quarter of 2020 , " said Derek Maetzold , president and chief executive officer of Castle Biosciences . " In - line with our expectations , January and February were impacted , we believe , by COVID - 19 and weather interruptions . However , we are encouraged by the positive trends that we are seeing . Specifically , we saw order volume for our DecisionDx® - Melanoma test increase by approximately 30 % in March 2021 , compared to January 2021 , with March orders being the highest March since DecisionDx - Melanoma became commercially available . This positive trend continued in April , with April orders exceeding those of March . Additionally , we saw continued positive trends for our recently launched DecisionDxⓇ - SCC and Decision Dx® DiffDxTM - Melanoma tests . While there is continued uncertainty related to the impact of COVID - 19 with regard to the timing of the return to historical levels of skin cancer diagnoses , we feel confident in providing 2021 revenue guidance of $ 80-83 million . " We continue to make progress on our growth initiatives and remain focused on helping physicians answer clinical questions with high unmet need with the personalized , precise results our genomic tests are designed to provide . We believe our recent announcement of signing a definitive agreement to acquire Myriad's my Path Melanoma laboratory , and the resulting addition of my Path® Melanoma test to our skin cancer test services , furthers our position as the leader in dermatologic diagnostics . And we believe this enables us to provide the most comprehensive offerings for patients with skin cancer and difficult - to - diagnose melanocytic lesions . Additionally , our pipeline initiative to develop an innovative test that can predict therapy response and guide treatment selection of systemic therapies in patients diagnosed with moderate to severe psoriasis , atopic dermatitis and related conditions has the potential to expand our reach into non - skin cancer , medical dermatology diseases and is expected to provide enhanced value to our clinical customers and their patients . These tests , along with our other pipeline products , have the potential to increase our estimated U.S. total addressable market to slightly more than $ 5.5 billion . " Finally , I am pleased to announce that we completed our commercial team expansion ahead of schedule , with all new outside territories filled , doubling our total dermatology customer facing positions to approximately 60-65 . Training is ongoing , and by July 1 , we expect our expanded commercial team will be able to utilize our existing , dermatologic sales channels to offer clinicians and their patients four innovative , actionable gene expression profile tests designed to improve patient care . " First Quarter Ended March 31 , 2021 , Selected Results • Revenues were $ 22.8 million , a 31 % increase compared to $ 17.4 million during the same period in 2020. Included in revenue for the period were positive revenue adjustments related to tests delivered in prior periods . These positive prior period revenue adjustments for the three months ended March 31 , 2021 , were $ 5.3 million , compared to $ 3.2 million for the same period in 2020. Prior period revenues for the first quarter of 2021 includes favorable adjustments related to settlement of certain groups of receivables from prior years , in addition to other positive prior period revenue adjustments . • Adjusted revenues were $ 17.5 million , a 22 % increase , excluding the effects of revenue adjustments related to tests delivered in prior periods , compared to $ 14.3 million for the same period in 2020 . • Total gene expression profile test reports delivered in the first quarter of 2021 were 5,142 , compared to 4,935 in the same period of 2020 : o DecisionDx - Melanoma test reports delivered in the first quarter of 2021 were 4,060 , compared to 4,574 , in the first quarter of 2020 . o Decision Dx - SCC test reports delivered in the first quarter of 2021 were 527 . o Decision Dx DiffDx - Melanoma test reports delivered in the first quarter of 2021 were 218 . ● o Decision Dx - UM test reports delivered in the first quarter of 2021 were 337 , compared to 361 in the first quarter of 2020. Order volume for Decision Dx - UM increased by approximately 58 % in March 2021 , compared to January 2021 . • Gross margin for the three months ended March 31 , 2021 , was 87 % . • Adjusted gross margin for the three months ended March 31 , 2021 , was 83 % . ● Operating cash flow was $ ( 3.6 ) million , compared to $ ( 0.3 ) million for the same period in 2020 . Adjusted operating cash flow was $ ( 5.5 ) million , compared to $ ( 0.3 ) million for the same period in 2020 .