Schneider Kevin J, Flaharty Kathryn G, Ellis Charles N, Bitar Obaidah M, Barinova Hanna, Tejasvi Trilokraj, Nelson Christine C
Department of Ophthalmology, University of Michigan Medical School, Ann Arbor, MI, USA.
Department of Dermatology, University of Michigan Medical School, Ann Arbor, MI, USA.
Heliyon. 2024 Apr 28;10(9):e30293. doi: 10.1016/j.heliyon.2024.e30293. eCollection 2024 May 15.
To determine if dermoscopy, a technique widely utilized in dermatology for improved diagnosis of skin lesions, can be used comfortably for evaluating periorbital, eyelid, and conjunctival lesions.
Proof-of-concept study in which a technique for performing dermoscopy near the eye was developed, related educational material was prepared, and a protocol for dermoscopic image capture was created.
Technicians used the developed materials to learn to take high-quality pictures with a 10x dermoscope attached to a standard cell phone camera. The images were assessed for diagnostic utility by an oculoplastic surgeon and two dermatologists.
115 patients recruited from ophthalmology clinics from July 2021 to April 2023 were photographed, yielding 129 lesions with high-quality dermoscopic images as assessed by an oculoplastic surgeon and two dermatologists.
Technicians reported a significant increase in confidence (measured on a 1-10 scale) with dermoscopy after training (pre-instruction mean = 1.72, median = 1, mode = 1, IQR = 1.25 vs mean = 7.69, median = 7.75, mode = 7 and 8, IQR = 1.5 post-instruction. Wilcoxon rank sum test with continuity correction, W = 0, p < 0.001, paired t = 13.95, < 0.0001). Incorporating a contact plate with a 4 × 4mm reticule on the dermoscope aided in photographing ocular and periocular lesions.
Medical support staff in eye-care offices can be taught to use dermoscopes to capture high-quality images of periorbital, eyelid, and conjunctival lesions. Dermoscopy illuminates diagnostic features of lesions and thus offers a new avenue to improve decision-making in ophthalmology. Dermoscopy can be incorporated into telemedicine evaluations by ophthalmologists, oculoplastic surgeons, or affiliated dermatologists for triage of or rendering advice to patients and for planning of surgery if needed.
确定皮肤镜检查（一种在皮肤科广泛应用以改善皮肤病变诊断的技术）是否能舒适地用于评估眶周、眼睑和结膜病变。
概念验证研究，其中开发了一种在眼部附近进行皮肤镜检查的技术，准备了相关教育材料，并创建了皮肤镜图像采集方案。
技术人员使用开发的材料学习使用连接到标准手机摄像头的10倍皮肤镜拍摄高质量照片。由一名眼整形医生和两名皮肤科医生评估这些图像的诊断效用。
2021年7月至2023年4月从眼科诊所招募的115名患者接受了拍照，经一名眼整形医生和两名皮肤科医生评估，获得了129个具有高质量皮肤镜图像的病变。
技术人员报告称，培训后使用皮肤镜检查的信心显著提高（采用1至10分制衡量）（培训前平均值=1.72，中位数=1，众数=1，四分位间距=1.25；培训后平均值=7.69，中位数=7.75，众数=7和8，四分位间距=1.5。连续性校正的Wilcoxon秩和检验，W=0，p<0.001，配对t=13.95，p<0.0001）。在皮肤镜上安装一个带有4×4毫米网格的接触板有助于拍摄眼部和眼周病变。
眼科护理机构的医疗辅助人员可以学会使用皮肤镜来采集眶周、眼睑和结膜病变的高质量图像。皮肤镜检查能够揭示病变的诊断特征，从而为改善眼科决策提供了一条新途径。皮肤镜检查可被眼科医生、眼整形医生或附属皮肤科医生纳入远程医疗评估，用于对患者进行分诊或提供建议，并在需要时用于手术规划。
