Norfolk and Norwich University Hospital, Colney Lane, Norwich, UK.
Clin Exp Dermatol. 2009 Dec;34(8):e876-8. doi: 10.1111/j.1365-2230.2009.03629.x.
Dermatoscopy is not accepted by all dermatologists as a useful diagnostic tool. We set out to test if training followed by regular clinical use of dermatoscopes improved diagnostic accuracy in melanoma diagnosis. Six dermatologists who had not previously used dermatoscopes were studied before and after a 10-month period of dermatoscope use with training and use of the Modified Pattern Analysis Diagnostic Algorithm. Diagnostic accuracy was assessed using test cards containing clinical and dermatoscopic photographs. The number of melanomas undiagnosed after training fell from 18 to 5 and the number potentially left unexcised fell from 18 to 3. The numbers of benign lesions potentially excised remained unchanged. The study shows that the use of dermatoscopes with training greatly increased the accuracy of diagnosis of melanoma by dermatologists. This practical study supports the use of dermatoscopy in pigmented-lesion diagnosis and demonstrates how dermatoscopy training could be incorporated into UK specialist training programmes.
皮肤镜检查并未被所有皮肤科医生都认可为一种有用的诊断工具。我们着手测试，如果对皮肤科医生进行培训并定期使用皮肤镜，是否能提高黑色素瘤诊断的准确性。我们研究了 6 名之前从未使用过皮肤镜的皮肤科医生，在经过 10 个月的培训和使用改良模式分析诊断算法后，对他们进行了前后对比。通过使用包含临床和皮肤镜照片的测试卡来评估诊断准确性。培训后，未被诊断出的黑色素瘤数量从 18 例减少到 5 例，可能未被切除的黑色素瘤数量从 18 例减少到 3 例。潜在可切除的良性病变数量保持不变。这项研究表明，使用带培训的皮肤镜大大提高了皮肤科医生诊断黑色素瘤的准确性。这项实际研究支持在色素性病变诊断中使用皮肤镜，并展示了如何将皮肤镜培训纳入英国专科培训计划。
