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深入探讨脂溢性角化病:患者视角、临床相关性、医疗必要性及管理启示

A Closer Look at Seborrheic Keratoses: Patient Perspectives, Clinical Relevance, Medical Necessity, and Implications for Management.

作者信息

Del Rosso James Q

机构信息

Research Director, JDR Dermatology Research and Private Dermatology Practice, Thomas Dermatology, Las Vegas, Nevada.

出版信息

J Clin Aesthet Dermatol. 2017 Mar;10(3):16-25. Epub 2017 Mar 1.

Abstract

The author sought to discover why seborrheic keratoses that are not symptomatic or clinically suspicious are not considered therapeutically important to most clinicians. The author conducted an office-based, observational study examining how the diagnosis of asymptomatic seborrheic keratoses personally affects patients and what these patients think concerning treatment. Many patients reported being bothered by the diagnosis of seborrheic keratoses, even when told it's not cancerous, and indicated an interest in its treatment. Lack of insurance coverage for the treatment of non-symptomatic seborrheic keratoses may be the primary reason clinicians do not consider seborrheic keratoses therapeutically important, as clinicians often find the discussion of "self payment" with their patients to be awkward. Furthermore, patients may not understand the implications that "lack of medical necessity" may have on their treatment options. The author describes a clinical approach that may better serve patients and clinicians through the compartmentalization of asymptomatic seborrheic keratoses treatment as a cosmetic procedure within the clinical practice model.

摘要

作者试图探究为什么对于大多数临床医生来说,无症状或临床上无可疑之处的脂溢性角化病在治疗上并不重要。作者开展了一项基于门诊的观察性研究,考察无症状脂溢性角化病的诊断对患者个人有何影响,以及这些患者对治疗的看法。许多患者报告称,即使被告知脂溢性角化病不是癌症,他们仍因该诊断而感到困扰,并表示对其治疗感兴趣。对于无症状脂溢性角化病的治疗缺乏保险覆盖,可能是临床医生不认为脂溢性角化病在治疗上重要的主要原因,因为临床医生常常觉得与患者讨论“自费”很尴尬。此外,患者可能不理解“缺乏医疗必要性”对其治疗选择可能产生的影响。作者描述了一种临床方法,通过将无症状脂溢性角化病的治疗在临床实践模式中作为一种美容程序进行分类,可能会更好地服务于患者和临床医生。

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