Monteiro Ana Filipe, Pinheiro Rita Ramos, Galhardas Célia, Lencastre André
Dermatology Department, Hospital de Santarém EPE, Santarém, Portugal.
Dermatovenereology Department, Hospital de Santo António dos Capuchos - Centro Hospitalar de Lisboa Central, Lisbon, Portugal.
Skin Appendage Disord. 2021 Jan;7(1):13-17. doi: 10.1159/000511283. Epub 2020 Nov 18.
Onychomycosis is one of the most common nail disorders and may be difficult to distinguish from other causes of nail dystrophy, based on clinical grounds alone. With this study, we aimed to describe the use of fungal testing by dermatologists and family physicians in their daily current practice, analyze their respective familiarity with nail disease diagnosis, and ultimately treatment decision-making by both groups. An online survey was distributed among Portuguese dermatologists, trainees, and family physicians by email. The survey focused on the diagnostic impression, use of diagnostic methods to confirm a fungal infection, and the subsequent assessment of treatment. One hundred fifty-one responses were obtained, 60 (39.7%) from dermatologists and 91 (60.3%) from family physicians; 98.3% of dermatologists mentioned usually requesting a fungal testing at their local institution or outside, while this percentage was 50.5% among family physicians ( < 0.001). Regarding the diagnosis, the median of correct diagnosis by the dermatologist group was higher (10/15) than the family physicians (6/15). Considering the treatment strategy, we observed that in the dermatologists' group it would result in unnecessary treatment in a median of 2 cases, while in the family physicians' group, in a median of 4 cases.
甲癣是最常见的指甲疾病之一，仅基于临床依据可能难以与其他导致指甲营养不良的原因相区分。通过本研究，我们旨在描述皮肤科医生和家庭医生在日常临床实践中真菌检测的使用情况，分析他们各自对指甲疾病诊断的熟悉程度，以及最终两组的治疗决策。通过电子邮件向葡萄牙的皮肤科医生、实习医生和家庭医生发放了一份在线调查问卷。该调查聚焦于诊断印象、用于确诊真菌感染的诊断方法以及后续的治疗评估。共获得151份回复，其中60份（39.7%）来自皮肤科医生，91份（60.3%）来自家庭医生；98.3%的皮肤科医生提到通常会在当地机构或外部要求进行真菌检测，而家庭医生中的这一比例为50.5%（<0.001）。关于诊断，皮肤科医生组正确诊断的中位数（10/15）高于家庭医生组（6/15）。考虑到治疗策略，我们观察到在皮肤科医生组中，中位数为2例会导致不必要的治疗，而在家庭医生组中，中位数为4例。
