Hofer T
Dermatologie FMH, Wettingen, Germany.
Hautarzt. 2002 Oct;53(10):666-71. doi: 10.1007/s00105-002-0410-4.
The campaign for early detection of malignant melanoma and the increase in people with photodamaged skin have a remarkable influence on the daily dermatological routine. Could these factors lead to the introduction of quality control in a private dermatology practice?
Over a period of one year the diagnoses of all patients were registered. The clinical diagnosis of any skin tumour undergoing surgical removal was compared with the final histopathological diagnosis.
56% of 3004 diagnoses involved females; 44%, males. In 40.5%, the possibility of a pigmented or non-pigmented skin tumour was raised. 49% of the 291 tumours removed were malignant (107 basal cell carcinoma, 20 squamous cell carcinoma, 16 melanoma) while 11.7% were malignant precursor lesions. 48% of 44 melanocytic naevi with clinical atypia showed histopathological dysplasia but none were a malignant melanoma. No cancers were detected among 59 clinically benign tumors. In 71.8% of cases, the clinical diagnosis agreed with the result of the histopathological examination.
This study shows, in concordance with literature, that a dermatologist can provide high quality treatment and prophylaxis of malignant skin tumours. With an optimal cost-performance ratio, he or she is the most competent partner for patients and health insurance companies.
恶性黑色素瘤早期检测活动以及光损伤皮肤人群的增加对日常皮肤科诊疗工作产生了显著影响。这些因素能否促使私立皮肤科诊所引入质量控制措施？
在一年时间内对所有患者的诊断情况进行登记。将接受手术切除的任何皮肤肿瘤的临床诊断与最终组织病理学诊断进行比较。
3004例诊断中，56%涉及女性，44%涉及男性。40.5%的病例中发现有色素沉着或无色素沉着的皮肤肿瘤。291例切除的肿瘤中，49%为恶性（107例基底细胞癌、20例鳞状细胞癌、16例黑色素瘤），11.7%为恶性前驱病变。44例临床非典型性黑素细胞痣中，48%显示组织病理学发育异常，但无1例为恶性黑色素瘤。59例临床诊断为良性的肿瘤中未检测到癌症。71.8%的病例中临床诊断与组织病理学检查结果一致。
本研究与文献一致表明，皮肤科医生能够为恶性皮肤肿瘤提供高质量的治疗和预防。以最佳的性价比，他或她是患者和健康保险公司最称职的合作伙伴。
