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Beltrami EJ, Gronbeck C, Jain N, Hargis G, Feng H, Grant-Kels JM, Sloan B. Surface anatomy in dermatology: Part I-Clinical importance, diagnostic utility, and impact on medical management. J Am Acad Dermatol 2024; 91:207-220. [PMID: 37429436 DOI: 10.1016/j.jaad.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 06/27/2023] [Accepted: 07/02/2023] [Indexed: 07/12/2023]
Abstract
This continuing medical education series reviews updated Delphi consensus surface anatomy terminology through the lens of common medical and procedural dermatology scenarios, helping to underscore high-yield points that can be readily integrated into clinical practice to support patient care. Part I of this series will discuss the current state of surface anatomy terminology in dermatology, outline implications of precise and consistent terminology, provide an illustrative overview of high-yield consensus terminology, highlight prominent landmarks that can aid in critical diagnoses, and relate the importance of precise terminology to medical management. Part II will draw upon consensus terminology to inform the management of cutaneous malignancies and support optimal outcomes in dermatologic procedures.
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Affiliation(s)
- Eric J Beltrami
- University of Connecticut School of Medicine, Farmington, Connecticut
| | - Christian Gronbeck
- Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut
| | - Neelesh Jain
- Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut
| | - Geneva Hargis
- University of Connecticut School of Medicine, Farmington, Connecticut
| | - Hao Feng
- Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut.
| | - Jane M Grant-Kels
- Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut; Department of Dermatology, University of Florida College of Medicine, Gainesville, Florida
| | - Brett Sloan
- Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut; VA Connecticut Healthcare System, West Haven, Connecticut
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2
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Reply to "Response to: 'Transparent grid system as a novel tool to prevent wrong-site skin surgery on the back'". J Am Acad Dermatol 2023; 88:e43. [PMID: 31923440 DOI: 10.1016/j.jaad.2019.12.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 12/31/2019] [Indexed: 11/20/2022]
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3
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The use of a portable black light (UV-A) flashlight to aid in biopsy site identification. J Am Acad Dermatol 2022; 87:e143-e144. [PMID: 34256036 DOI: 10.1016/j.jaad.2021.06.881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 06/23/2021] [Accepted: 06/28/2021] [Indexed: 11/22/2022]
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Jueng JJ, Desai AS, Kohli N. Photographic Confirmation of Biopsy Sites Saves Lives. Fed Pract 2021; 38:227-231. [PMID: 34177232 DOI: 10.12788/fp.0055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Quality photographic documentation of lesions prior to biopsy can decrease the risk of wrong site surgery, improve patient care, and save lives.
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Affiliation(s)
- Jeremy J Jueng
- is a Medical Student and is an Assistant Professor of Dermatology at the University of Central Florida College of Medicine in Orlando. is a Resident Physician at University of Florida in Gainesville. Nita Kohli is a Physician at the Gulf Coast Veterans Health Care Center in Biloxi, Mississippi
| | - Anand S Desai
- is a Medical Student and is an Assistant Professor of Dermatology at the University of Central Florida College of Medicine in Orlando. is a Resident Physician at University of Florida in Gainesville. Nita Kohli is a Physician at the Gulf Coast Veterans Health Care Center in Biloxi, Mississippi
| | - Nita Kohli
- is a Medical Student and is an Assistant Professor of Dermatology at the University of Central Florida College of Medicine in Orlando. is a Resident Physician at University of Florida in Gainesville. Nita Kohli is a Physician at the Gulf Coast Veterans Health Care Center in Biloxi, Mississippi
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Strickler AG, Shah P, Bajaj S, Mizuguchi R, Nijhawan RI, Odueyungbo M, Rossi A, Ratner D. Preventing complications in dermatologic surgery: Presurgical concerns. J Am Acad Dermatol 2021; 84:883-892. [PMID: 33497750 DOI: 10.1016/j.jaad.2020.10.099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 01/19/2023]
Abstract
Cutaneous surgery has become critical to comprehensive dermatologic care, and dermatologists must therefore be equipped to manage the risks associated with surgical procedures. Complications may occur at any point along the continuum of care, and therefore assessing, managing, and preventing risk from beginning to end becomes essential. This review focuses on preventing surgical complications pre- and postoperatively as well as during the surgical procedure.
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Affiliation(s)
- Allen G Strickler
- Department of Dermatology, Geisinger Medical Center of Geisinger Commonwealth School of Medicine, Danville, Pennsylvania; Department of Laboratory Medicine, Geisinger Medical Center of Geisinger Commonwealth School of Medicine, Danville, Pennsylvania.
| | - Payal Shah
- School of Medicine, New York University Langone Health, New York, New York
| | - Shirin Bajaj
- Department of Dermatology, New York University Langone Health, New York, New York
| | - Richard Mizuguchi
- Department of Dermatology, Mount Sinai Medical School, New York, New York
| | - Rajiv I Nijhawan
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas
| | | | - Anthony Rossi
- Weill Cornell Medical College, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Désirée Ratner
- Department of Dermatology, New York University Langone Health, New York, New York
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Navarrete-Dechent C, Liopyris K, Molenda MA, Braun R, Curiel-Lewandrowski C, Dusza SW, Guitera P, Hofmann-Wellenhof R, Kittler H, Lallas A, Malvehy J, Marchetti MA, Oliviero M, Pellacani G, Puig S, Soyer HP, Tejasvi T, Thomas L, Tschandl P, Scope A, Marghoob AA, Halpern AC. Human surface anatomy terminology for dermatology: a Delphi consensus from the International Skin Imaging Collaboration. J Eur Acad Dermatol Venereol 2020; 34:2659-2663. [PMID: 32770737 DOI: 10.1111/jdv.16855] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 07/29/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND There is no internationally vetted set of anatomic terms to describe human surface anatomy. OBJECTIVE To establish expert consensus on a standardized set of terms that describe clinically relevant human surface anatomy. METHODS We conducted a Delphi consensus on surface anatomy terminology between July 2017 and July 2019. The initial survey included 385 anatomic terms, organized in seven levels of hierarchy. If agreement exceeded the 75% established threshold, the term was considered 'accepted' and included in the final list. Terms added by the participants were passed on to the next round of consensus. Terms with <75% agreement were included in subsequent surveys along with alternative terms proposed by participants until agreement was reached on all terms. RESULTS The Delphi included 21 participants. We found consensus (≥75% agreement) on 361/385 (93.8%) terms and eliminated one term in the first round. Of 49 new terms suggested by participants, 45 were added via consensus. To adjust for a recently published International Classification of Diseases-Surface Topography list of terms, a third survey including 111 discrepant terms was sent to participants. Finally, a total of 513 terms reached agreement via the Delphi method. CONCLUSIONS We have established a set of 513 clinically relevant terms for denoting human surface anatomy, towards the use of standardized terminology in dermatologic documentation.
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Affiliation(s)
- C Navarrete-Dechent
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - K Liopyris
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Andreas Syggros Hospital of Cutaneous & Venereal Diseases, University of Athens, Athens, Greece
| | | | - R Braun
- Department of Dermatology, University Hospital Zürich, Zurich, Switzerland
| | - C Curiel-Lewandrowski
- Department of Dermatology, The University of Arizona Cancer Center, University of Arizona, Tucson, AZ, USA
| | - S W Dusza
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - P Guitera
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
| | | | - H Kittler
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - A Lallas
- First Department of Dermatology, Aristotle University, Thessaloniki, Greece
| | - J Malvehy
- Melanoma Unit, Department of Dermatology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.,CIBER de Enfermedades Raras, Instituto de Salud Carlos III, Barcelona, Spain
| | - M A Marchetti
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - M Oliviero
- Dermatology Associates, Plantation, FL, USA
| | - G Pellacani
- Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy
| | - S Puig
- Melanoma Unit, Department of Dermatology, Hospital Clinic, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain.,CIBER de Enfermedades Raras, Instituto de Salud Carlos III, Barcelona, Spain
| | - H P Soyer
- Dermatology Research Center, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, Australia
| | - T Tejasvi
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - L Thomas
- Service de Dermatologie, Centre Hospitalier Lyon Sud, Lyon 1 University and Cancer Research Center of Lyons INSERM U1052 - CNRS UMR5286, Lyon, France
| | - P Tschandl
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - A Scope
- The Kittner Skin Cancer Screening and Research Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A A Marghoob
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - A C Halpern
- Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Kopke LFF. The importance of residual tumor detection. An Bras Dermatol 2019; 94:374-375. [PMID: 31365678 PMCID: PMC6668955 DOI: 10.1590/abd1806-4841.20198074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 07/26/2018] [Indexed: 11/22/2022] Open
Affiliation(s)
- Luis Fernando Figueiredo Kopke
- Outpatient Surgery Division, Dermatology Service, Hospital
Universitário Polydoro Ernani de São Thiago, Universidade Federal
de Santa Catarina, Florianópolis (SC), Brazil
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Smith C, Srivastava D, Nijhawan RI. Optimizing Patient Safety in Dermatologic Surgery. Dermatol Clin 2019; 37:319-328. [DOI: 10.1016/j.det.2019.02.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Smartphones in Dermatology: Acceptance of Smartphone Photography by the Informed Patient. Dermatol Surg 2019; 46:1131-1133. [PMID: 31246873 DOI: 10.1097/dss.0000000000001976] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Chen L, Parsons AM, Aria AB, Ciurea AM, Patel AB, Chan C, Griffin JR, Nguyen TH, Migden MR. Surgical site identification with personal digital device: A prospective pilot study. J Am Acad Dermatol 2018. [PMID: 29524583 DOI: 10.1016/j.jaad.2018.02.069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Various means to facilit ate accurate biopsy site identification have been proposed. OBJECTIVE To determine the accuracy of biopsy site identification by using photographs taken with a patient's digital device by a dermatologist versus professional medical photography. METHODS Photographs of circled biopsy sites were taken with personal digital devices by the principal investigator (PI). Another set of photographs was taken by a professional photographer. Secondary photographs were taken of the biopsy site location pointed to by the staff and PI on the basis of the personal digital device image and professional medical photography, respectively. On the basis of secondary photographs, 2 independent dermatologists determined whether the skin biopsy locations pointed out by the staff were consistent with the ones pointed out by PI. RESULTS Per dermatologist A, the staff correctly identified all 53 biopsy sites. Per dermatologist B, the staff were correct on 51 of 53 observations. Dermatologist C, the final arbiter, concurred with dermatologist A on the 2 cases in which dermatologist B was not certain of the location of the biopsy site. LIMITATIONS The mean interval from initial biopsy to reidentification of the site was 36.2 days. CONCLUSION Utilizing patients' personal digital devices is a cost-effective, Health Insurance Portability and Accountability Act-compliant, and readily available means to identify skin biopsy sites.
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Affiliation(s)
- Leon Chen
- Department of Dermatology, The University of Texas McGovern Medical School at Houston, Fort Worth, Texas
| | - Adam M Parsons
- Texas Center for Orthopedic and Spinal Disease, Fort Worth, Texas
| | - Alexander B Aria
- Department of Dermatology, The University of Texas McGovern Medical School at Houston, Fort Worth, Texas
| | - Ana M Ciurea
- Department of Dermatology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Anisha B Patel
- Department of Dermatology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | - Christopher Chan
- Department of Dermatology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas
| | | | | | - Michael R Migden
- Department of Dermatology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas; Department of Head and Neck Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, Texas.
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Zhang J, Rosen A, Orenstein L, Van Voorhees A, Miller CJ, Sobanko JF, Shin TM, Etzkorn JR. Factors associated with biopsy site identification, postponement of surgery, and patient confidence in a dermatologic surgery practice. J Am Acad Dermatol 2016; 74:1185-93. [DOI: 10.1016/j.jaad.2015.12.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 12/06/2015] [Accepted: 12/08/2015] [Indexed: 11/27/2022]
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14
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Error Avoidance in Dermatologic Surgery. CURRENT DERMATOLOGY REPORTS 2015. [DOI: 10.1007/s13671-015-0112-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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15
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Hansen TJ, Lolis M, Goldberg DJ, MacFarlane DF. Patient safety in dermatologic surgery. J Am Acad Dermatol 2015; 73:1-12; quiz 13-4. [DOI: 10.1016/j.jaad.2014.10.047] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 10/11/2014] [Accepted: 10/14/2014] [Indexed: 11/26/2022]
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Graybill-D'Ercole P. RP implementation: specimen management. AORN J 2014; 100:625-33; quiz 634-6. [PMID: 25453682 DOI: 10.1016/j.aorn.2014.10.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 10/07/2014] [Accepted: 10/07/2014] [Indexed: 11/25/2022]
Abstract
Effective specimen management in the perioperative setting is essential for accurate patient diagnosis and intervention. AORN's "Recommended practices for specimen management" provides guidance to help perioperative nurses, in collaboration with a multidisciplinary team, implement a specimen management process that includes a needs assessment, site identification, collection and handling, transfer from the sterile field, containment, specimen identification and labeling, preservation, transport, disposition, and documentation. Accurate specimen management requires effective multidisciplinary communication and an awareness of the potential opportunities for error. Specimens discussed in the recommended practices document include breast cancer specimens, amputated digits and limbs to be reattached, forensic and radioactive specimens, and explanted medical devices and orthopedic hardware. The recommendations are applicable to both hospital and ambulatory settings.
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Jawed SI, Goldberg LH, Wang SQ. Dermoscopy to identify biopsy sites before Mohs surgery. Dermatol Surg 2014; 40:334-7. [PMID: 24447179 DOI: 10.1111/dsu.12422] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Sarah I Jawed
- Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, New York
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Lichtman MK, Countryman NB. Cell Phone-Assisted Identification of Surgery Site. Dermatol Surg 2013; 39:491-2. [DOI: 10.1111/dsu.12109] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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