The Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
Clinical School, University of Cambridge, Cambridge, UK.
J Eur Acad Dermatol Venereol. 2019 Sep;33(9):1706-1712. doi: 10.1111/jdv.15614. Epub 2019 May 17.
Melanoma accounts for 90% of skin cancer mortality and typically presents in primary care, where it can be challenging to distinguish from benign lesions. Dermoscopy is a tool for skin visualization that is routinely used for melanoma diagnosis in secondary care. However, the role of dermoscopy in primary care remains unclear.
To determine views on, and use of, dermoscopy by dermatology-interested general practitioners (GPs).
An online questionnaire was emailed to the UK Primary Care Dermatology Society members in February 2018, and responses collected over the following 4 weeks.
A total of 205 responses were analysed. Most respondents were GPs (94%), aged over 50 (53%), had a postgraduate dermatological qualification (67%) and used dermoscopy regularly when reviewing pigmented skin lesions (97%). Dermoscopy use was commoner amongst GPs who had worked longer in primary care and had experience of secondary care dermatology. Most had undertaken training in dermoscopy (91%), although one-fifth (20%) had not updated their training in over 5 years. Most of those who had received only 1 day of face-to-face training reported feeling confident using a dermatoscope. Few respondents (11%) reported access to teledermatology or teledermoscopy for urgent or routine referrals.
UK GPs with a special interest in dermatology are routinely using dermoscopy in the primary care setting. More research is needed to establish optimal approaches to training and updating GP dermoscopy skills. When dermoscopy has been shown to be safe, effective, acceptable and cost-effective in this setting, more GPs may also be able to gain and maintain the skills to implement dermoscopy into routine primary care. Technological advances, including incorporation of artificial intelligence (AI) and algorithms to guide GPs, could also contribute to widening use of dermoscopy among GPs.
黑色素瘤是皮肤癌死亡的 90%，通常在初级保健中出现，在那里很难将其与良性病变区分开来。皮肤镜检查是一种用于皮肤可视化的工具，在二级保健中常用于黑色素瘤诊断。然而，皮肤镜检查在初级保健中的作用仍不清楚。
确定皮肤科感兴趣的全科医生（GP）对皮肤镜检查的看法和使用情况。
2018 年 2 月，向英国初级保健皮肤科协会成员发送了一份在线问卷，并在接下来的 4 周内收集了回复。
共分析了 205 份回复。大多数受访者是全科医生（94%），年龄在 50 岁以上（53%），具有皮肤科研究生学历（67%），并经常在审查色素性皮肤病变时使用皮肤镜检查（97%）。在从事初级保健工作时间较长且有二级保健皮肤科经验的 GP 中，皮肤镜检查的使用更为普遍。大多数人都接受过皮肤镜检查培训（91%），尽管五分之一（20%）的人在过去 5 年以上没有更新过培训。那些仅接受过 1 天面对面培训的人中，大多数人报告说对使用皮肤镜检查有信心。很少有受访者（11%）报告说可以获得远程皮肤病学或远程皮肤镜检查来进行紧急或常规转诊。
对皮肤科有特殊兴趣的英国全科医生在初级保健环境中常规使用皮肤镜检查。需要更多的研究来确定培训和更新全科医生皮肤镜检查技能的最佳方法。当皮肤镜检查在这种情况下已被证明是安全、有效、可接受且具有成本效益时，更多的全科医生也可能能够获得并保持将皮肤镜检查纳入常规初级保健的技能。包括人工智能（AI）和算法在内的技术进步也可以促进全科医生更广泛地使用皮肤镜检查。
