Drugge Elizabeth D, Okundaye Osatohamwen I, Sarac Rebecca M, Drugge Rhett J
New York Medical College, Valhalla, NY.
Dermatol Online J. 2019 Jul 15;25(7):13030/qt33h4r9bk.
The current standard of care for high-risk melanoma patients is a two-step process using Total Body Photography (TBP) followed by dermoscopy and is limited to a select group of patients. Methods: A cross-sectional study of patient characteristics and self-reported melanoma risk factors associated with TBP usage and pathology-confirmed outcomes was conducted on a sample of 4,692 patients in a single practitioner private dermatology setting. Results: TBP patients were significantly more likely to be male, partnered, tobacco users, highly educated, and have increased self-reported risk factors (such as fair skin, personal history of skin cancer or melanoma, family history of skin cancer, numerous moles, or previous history of sunburn, P<0.05). Personal history of skin cancer and melanoma, male gender, ?40 moles, Medicare insurance, and increasing age were positively associated with malignancy outcomes, whereas higher education, family history of melanoma, and traditional (private) insurance were associated with reduced prevalence of malignant lesions. Patients' self-assessed skin cancer risk and access to skin detection modalities can result in detection of melanoma at early, curable stages. Higher level of education and partner status may result in a greater awareness of risk factors associated with melanoma.
目前，高危黑色素瘤患者的标准治疗方案是一个分两步走的过程，即先进行全身摄影（TBP），然后进行皮肤镜检查，且仅限于特定的患者群体。方法：在一名私人皮肤科医生的诊所中，对4692名患者进行了一项横断面研究，分析患者特征以及与使用TBP和病理确诊结果相关的自我报告的黑色素瘤风险因素。结果：使用TBP的患者显著更有可能为男性、已婚、吸烟、受过高等教育，且自我报告的风险因素增加（如皮肤白皙、有皮肤癌或黑色素瘤个人病史、皮肤癌家族史、痣数量众多或既往晒伤史，P<0.05）。皮肤癌和黑色素瘤个人病史、男性、40颗以上痣、医疗保险以及年龄增长与恶性病变结果呈正相关，而高等教育、黑色素瘤家族史以及传统（私人）保险与恶性病变患病率降低相关。患者自我评估的皮肤癌风险以及获得皮肤检测方式的机会可促使在可治愈的早期阶段发现黑色素瘤。较高的教育水平和伴侣状况可能会使人们对与黑色素瘤相关的风险因素有更高的认识。
