Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
JAMA Dermatol. 2018 Oct 1;154(10):1204-1207. doi: 10.1001/jamadermatol.2018.2531.
Cardiovascular implanted electronic devices (CIEDs) are susceptible to electromagnetic interference. Dermatologists regularly use devices containing magnets, including dermatoscopes and their attachments, which could pose a hazard to patients with CIEDs.
To investigate the safety risk of magnets in dermatoscopes to patients with CIEDs.
DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional observational study was conducted between January 1, 2018, and March 31, 2018, in a controlled laboratory setting. Two experiments were performed. In the first experiment (performed in the Dermatology Service at Memorial Sloan Kettering Cancer Center, New York), dermatoscopes that contain magnets were obtained from 3 manufacturers. Using a magnometer, the magnetic field strength of the dermatoscopes was measured over the magnet; at the faceplate; and at a distance of 0.5 cm, 1 cm and 15 cm away from the faceplate. In the second experiment (performed in the University Heart Center Zurich, Zurich, Switzerland), ex vivo measurements were conducted to determine how the dermatoscopes affected old-generation and new generation CIEDs (pacemakers and implantable defibrillators).
Magnetic field strength as measured directly over the dermatoscope magnet; at the faceplate; and at distances of 0.5 cm, 1 cm, and 15 cm from the faceplate. Pacemaker and defibrillator operation when exposed to dermatoscopes.
After conducting 24 measurements, the magnetic field (measured in gauss [G]) strength varied between 24.26 G and 163.04 G over the dermatoscope magnet, between 2.22 G and 9.98 G at the dermatoscope faceplate, between 0.82 G and 2.4 G at a distance of 0.5 cm, and between 0.5 G and 1.04 G at a distance of 1 cm; it was 0 for all devices at a 15 cm distance. The field strength at the faceplate was found to be generally below the CIED industry standard safety threshold. None of the dermatoscopes in the ex vivo experiment exerted any demonstrable disruptions or changes to the CIEDs.
In real life, dermatoscope magnets likely present no measurable safety risk to patients with CIEDs. Using the polarized noncontact mode permits dermoscopy to be performed at least 0.5 cm from the skin surface, where the magnetic field strength was well below the 5-G safety threshold.
心血管植入式电子设备（CIEDs）易受电磁干扰。皮肤科医生经常使用内置磁铁的设备，包括皮肤科显微镜及其附件，这可能对 CIED 患者构成危险。
研究皮肤科显微镜中的磁铁对 CIED 患者的安全风险。
设计、设置和参与者：这是一项横断面观察性研究，于 2018 年 1 月 1 日至 2018 年 3 月 31 日在受控实验室环境中进行。进行了两项实验。在第一项实验（在纽约 Memorial Sloan Kettering 癌症中心皮肤科进行）中，从 3 家制造商获得了内置磁铁的皮肤科显微镜。使用磁力计测量显微镜磁铁上、面板上以及距离面板 0.5 厘米、1 厘米和 15 厘米处的磁场强度。在第二项实验（在瑞士苏黎世大学心脏中心进行）中，进行了离体测量以确定皮肤科显微镜如何影响旧代和新一代 CIED（起搏器和植入式除颤器）。
直接在皮肤科显微镜磁铁上、在面板上以及在距面板 0.5 厘米、1 厘米和 15 厘米处测量的磁场强度。暴露于皮肤科显微镜时起搏器和除颤器的运行情况。
在进行了 24 次测量后，在皮肤科显微镜磁铁上的磁场（以高斯[G]测量）强度在 24.26G 和 163.04G 之间变化，在皮肤科显微镜面板上的磁场强度在 2.22G 和 9.98G 之间变化，在距离 0.5 厘米处的磁场强度在 0.82G 和 2.4G 之间变化，在距离 1 厘米处的磁场强度在 0.5G 和 1.04G 之间变化；在 15 厘米的距离处，所有设备的磁场强度均为 0。发现面板上的场强通常低于 CIED 行业标准安全阈值。离体实验中的任何皮肤科显微镜都未对 CIED 产生任何可察觉的干扰或变化。
在现实生活中，皮肤科显微镜磁铁对 CIED 患者可能不存在可测量的安全风险。使用偏振非接触模式可以在距皮肤表面至少 0.5 厘米的地方进行皮肤镜检查，在此距离处磁场强度远低于 5G 安全阈值。
