Suspected skin malignancy: a comparison of diagnoses of family practitioners and dermatologists in 493 patients

International Journal of Dermatology - Tập 40 Số 2 - Trang 104-107 - 2001
Antoinette Morrison1, Sean O’Loughlin1, Frank C. Powell1
1From the Regional Centre of Dermatology, Mater Misericordiae Hospital, Dublin, Ireland

Tóm tắt

AbstractBackground  In the Irish health system, dermatology patients present to their family practitioner for diagnosis and treatment, and are referred to a dermatologist for a second opinion where diagnosis is in doubt or when there has been therapeutic failure. The level of expertise in dermatology amongst family practitioners varies considerably.Aim  To compare the diagnoses of general practitioners and dermatologists over a selected period in patients with a possible diagnosis of skin cancer.Methods  Four hundred and ninety‐three patients were seen by one of two dermatologists over a 1‐year period at a rapid referral clinic for patients suspected by their family practitioners of having unstable or possibly malignant skin lesions; 213 of these patients had a diagnosis made on clinical examination by the dermatologist, while 264 had diagnostic or therapeutic biopsies performed; 16 patients defaulted on surgery.Results  The diagnoses of the family practitioners agreed with the diagnoses of the dermatologists on patients diagnosed clinically in 54% of cases. Thirty‐eight patients had histologically proven skin malignancy. These were diagnosed accurately by the referring family practitioner in 22% of patients, while the dermatologists made the correct diagnosis prior to biopsy in 87%.Conclusions  In over 50% of cases diagnosed clinically, the dermatologist and family practitioner agreed. Histologically proven skin cancers were diagnosed accurately in only 22% of cases by family practitioners, compared to 87% of cases by dermatologists. Specific areas of diagnostic difficulty for family practitioners include benign pigmented actinic and seborrheic keratoses, squamous cell carcinoma, and melanoma. Postgraduate education for family practitioners should be directed towards these areas of deficiency. Dermatologists had difficulty distinguishing pigmented actinic keratoses from melanoma.

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Tài liệu tham khảo

Rampen FHJ, 1988, Referral pattern and accuracy of clinical diagnosis of cutaneous melanoma, Acta Derm Venereol (Stockh), 68, 61

10.1159/000247538

Ramsay D, 1981, The ability of primary care physicians to recognise the common dermatoses, Arch Dermatol, 117, 620, 10.1001/archderm.1981.01650100022020

10.1111/j.1524-4725.1985.tb01406.x

10.1016/S0190-9622(86)70068-6

10.1046/j.1365-2133.1996.d01-935.x

Fiddeiro T Tavades Bello RC Feic A Fernandes Rodrignes JC.Basal‐cell carcinoma: diagnostic accuracy.Skin Cancer1991; 1988–894E6 9–13.

Presser SE&Taylor R.Clinical diagnostic accuracy of basal cell carcinoma.J Am Acad Dermatol1987;16 988–990.

10.1001/archderm.1965.01600110083017

10.1016/0190-9622(95)90011-X

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Thông tin xuất bản

International Journal of Dermatology

Tập 40 Số 2

104-107

Thông tin tác giả