Outcomes of dermoscope-guided surgical procedures in primary care: case-control study

被引:3
作者
Chuh, Antonio [1 ,2 ,3 ]
Zawar, Vijay [4 ]
Sciallis, Gabriel [5 ]
Folster-Holst, Regina [6 ]
机构
[1] Univ Hong Kong, Dept Family Med & Primary Care, Pokfulam, Hong Kong, Peoples R China
[2] Queen Mary Hosp, Pokfulam, Hong Kong, Peoples R China
[3] Hong Kong Soc Primary Care Dermoscopy, Hong Kong, Peoples R China
[4] Dr Vasantrao Pawar Med Coll, Dept Dermatol, Nasik, India
[5] Mayo Clin & Mayo Grad Sch Med, Dept Dermatol, Rochester, MI USA
[6] Univ Klinikum Schleswig Holstein, Dermatol Venerol & Allergol, Campus Kiel, Kiel, Germany
关键词
Dermoscopy; general practice; laser procedures; primary health care; skin biopsy; skin microscopy; BIOPSY;
D O I
10.1071/HC18064
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
INTRODUCTION No research has been found regarding outcomes of dermoscope-guided surgical procedures in primary care. AIM To establish whether outcomes of dermoscope-guided procedures performed in primary care settings differ from outcomes for similar procedures, performed without the use of a dermoscope. METHODS A retrospective case-control study design was used. All records of dermoscope-guided procedures performed over a 6-month period were retrieved. For each study procedure, the record of the most recent control procedure without dermoscopy guidance performed on a sex-and-age matched patient was retrieved from before we began performing dermoscope-guided procedures. Primary outcomes were: local inflammation and infections within 2 weeks' post procedure; relapse in 6 months; and obvious scars in 6 months. Pain affecting activities of daily living in the first week after the procedure was the secondary outcome. RESULTS Records of 39 dermoscope-guided procedures and 39 control procedures were retrieved. No significant difference in local inflammation and infections in 2 weeks was found; relapse in 6 months after the study procedures was significantly lower for dermoscope-guided than control procedures (risk ratio (RR): 0.22; 95% confidence interval (CI): 0.05-0.95), and there were fewer obvious scars for dermoscope-guided procedures than control procedures (RR: 0.52; 95% CI: 0.32-0.83), with the number of small lesions (<4 mm) leaving scars in study procedures particularly less than that for control procedures (RR: 0.30; 95% CI: 0.13-0.67). There was no difference in the secondary outcome of pain affecting activities of daily living in the first week following the procedure. CONCLUSION In primary care, dermoscope-guided procedures achieved better outcomes than similar procedures without dermoscope guidance. Performing dermoscope-guided procedures in primary care might lower medical costs.
引用
收藏
页码:54 / 63
页数:10
相关论文
共 16 条
[1]   Dermoscopy and Onychomycosis: guided nail abrasion for mycological samples [J].
Bet, Diego Leonardo ;
dos Reis, Ana Lucia ;
Di Chiacchio, Nilton ;
Belda Junior, Walter .
ANAIS BRASILEIROS DE DERMATOLOGIA, 2015, 90 (06) :904-906
[2]   Biopsy guided by dermoscopy in cutaneous pigmented lesion - Case report [J].
Bomm, Lislaine ;
Villela Benez, Marcela Duarte ;
Pineiro Maceira, Juan Manuel ;
Brasil Succi, Isabel Cristina ;
Guimaraes Scotelaro, Maria de Fatima .
ANAIS BRASILEIROS DE DERMATOLOGIA, 2013, 88 (01) :125-127
[3]   Preoperative margin detection by digital dermoscopy in the traditional surgical excision of cutaneous squamous cell carcinomas [J].
Carducci, Mauro ;
Bozzetti, Marcella ;
de Marco, Giuseppe ;
Foscolo, Anna Maria ;
Betti, Roberto .
JOURNAL OF DERMATOLOGICAL TREATMENT, 2013, 24 (03) :221-226
[4]   Dermoscope-guided lesional biopsy to diagnose EMA+CK7+CK20+extramammary Paget's disease with an extensive lesion [J].
Chuh, A. ;
Zawar, V. ;
Foelster-Holst, R. .
JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY, 2018, 32 (03) :E92-E94
[5]  
Chuh A, 2017, INT J TROP DIS HLTH, V24, P1, DOI [10.9734/IJTDH/2017/34851, DOI 10.9734/IJTDH/2017/34851]
[6]  
Chuh A, 2017, DERMATOLOGY, V27, P134
[7]   Dermatoscope-guided suturing for an open wound adjacent to the lacrimal sac and the nasolacrimal duct [J].
Chuh, Antonio .
AUSTRALASIAN JOURNAL OF DERMATOLOGY, 2018, 59 (02) :153-154
[8]  
Chuh Antonio A T, 2005, Aust Fam Physician, V34, P347
[9]   Epiluminescence Microscopy (Dermoscopy) Versus Visual Inspection During Mohs Microscopic Surgery of Infiltrative Basal Cell Carcinoma [J].
Gurgen, Johnny ;
Gatti, Mia .
DERMATOLOGIC SURGERY, 2012, 38 (07) :1066-1069
[10]   Dermoscopy to Identify Biopsy Sites Before Mohs Surgery [J].
Jawed, Sarah I. ;
Goldberg, Leonard H. ;
Wang, Steven Q. .
DERMATOLOGIC SURGERY, 2014, 40 (03) :334-337