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Li X, Zhao M, Li Y, Zhang A, Liu Y, Li J, Li D, Guo J, Ma L, Mu Q. Enhancing diagnostic accuracy in common human poxvirus infections during mpox outbreak: A dermoscopy review. Skin Res Technol 2023; 29:e13489. [PMID: 37881051 PMCID: PMC10541801 DOI: 10.1111/srt.13489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 09/23/2023] [Indexed: 10/27/2023]
Abstract
Poxviruses belong to the Poxviridae family, a group of pathogens known for their high infectivity in humans, posing significant health threats. One of the most well-known representatives of poxvirus infections is smallpox, which has been successfully eradicated. However, in recent years, there has been a resurgence in cases of mpox, another member of the Poxviridae family, raising concerns about the potential for a global pandemic or a worldwide health crisis. While the typical clinical presentation of mpox and other poxvirus infections often involves cutaneous lesions, there have been reports of various atypical and non-classic clinical manifestations. Dermoscopy has emerged as a crucial diagnostic tool, aiding dermatologists in clinical practice to make informed decisions. In this summary, we provide an overview of the clinical and dermoscopic features of representative cutaneous lesions associated with human poxvirus infections, including mpox, orf, milker's nodule, and molluscum contagiosum.
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Affiliation(s)
- Xu Li
- Department of DermatologyThe First Hospital of HohhotHohhotChina
- Department of AllergyThe First Hospital of HohhotHohhotChina
| | - Mutong Zhao
- Department of DermatologyBeijing Children's HospitalCapital Medical UniversityNational Center for Children's HealthBeijingChina
| | - Yanfei Li
- Department of DermatologyThe First Hospital of HohhotHohhotChina
- Department of AllergyThe First Hospital of HohhotHohhotChina
| | - Anda Zhang
- Department of DermatologyInternational Mongolian Hospital of Inner MongoliaHohhotChina
| | - Ying Liu
- Department of DermatologyBeijing Children's HospitalCapital Medical UniversityNational Center for Children's HealthBeijingChina
| | - Jiaojiao Li
- Department of DermatologyThe First Hospital of HohhotHohhotChina
| | - Dan Li
- Department of DermatologyThe First Hospital of HohhotHohhotChina
| | - Jingxue Guo
- Department of DermatologyThe First Hospital of HohhotHohhotChina
| | - Lin Ma
- Department of DermatologyBeijing Children's HospitalCapital Medical UniversityNational Center for Children's HealthBeijingChina
| | - Qiri Mu
- Department of DermatologyInternational Mongolian Hospital of Inner MongoliaHohhotChina
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2
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Lee C, Witkowski A, Żychowska M, Ludzik J. The role of mobile teledermoscopy in skin cancer triage and management during the COVID-19 pandemic. Indian J Dermatol Venereol Leprol 2022; 89:347-352. [PMID: 36688890 DOI: 10.25259/ijdvl_118_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 04/01/2022] [Indexed: 12/13/2022]
Abstract
The unprecedented onset of the COVID-19 crisis poses a significant challenge to all fields of medicine, including dermatology. Since the start of the coronavirus outbreak, a stark decline in new skin cancer diagnoses has been reported by countries worldwide. One of the greatest challenges during the pandemic has been the reduced access to face-to-face dermatologic evaluation and non-urgent procedures, such as biopsies or surgical excisions. Teledermatology is a well-integrated alternative when face-to-face dermatological assistance is not available. Teledermoscopy, an extension of teledermatology, comprises consulting dermoscopic images to improve the remote assessment of pigmented and non-pigmented lesions when direct visualisation of lesions is difficult. One of teledermoscopy's greatest strengths may be its utility as a triage and monitoring tool, which is critical in the early detection of skin cancer, as it can reduce the number of unnecessary referrals, wait times, and the cost of providing and receiving dermatological care. Mobile teledermoscopy may act as a communication tool between medical practitioners and patients. By using their smartphone (mobile phone) patients can monitor a suspicious skin lesion identified by their medical practitioner, or alternatively self-detect concerning lesions and forward valuable dermoscopic images for remote medical evaluation. Several mobile applications that allow users to photograph suspicious lesions with their smartphones and have them evaluated using artificial intelligence technology have recently emerged. With the growing popularity of mobile apps and consumer-involved healthcare, this will likely be a key component of skin cancer screening in the years to come. However, most of these applications apply artificial intelligence technology to assess clinical images rather than dermoscopic images, which may lead to lower diagnostic accuracy. Incorporating the direct-to-consumer mobile dermoscopy model in combination with mole-scanning artificial intelligence as a mobile app may be the future of skin cancer detection.
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Affiliation(s)
- Claudia Lee
- Department of Medicine, University of California Riverside, Riverside, California, United States
| | - Alexander Witkowski
- Department of Dermatology, Oregon Health and Sciences University, Portland, Oregon, United States
| | - Magdalena Żychowska
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland
| | - Joanna Ludzik
- Department of Dermatology, Oregon Health and Sciences University, Portland, Oregon, United States
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3
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Zhang LW, Fu LX, Wang WJ, Chen T. A simple modification to prevent the cross-infection by dermoscopy. Clin Exp Dermatol 2022; 47:1577-1578. [PMID: 35340029 DOI: 10.1111/ced.15198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 03/23/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Li-Wen Zhang
- Department of Dermatovenereology, Chengdu Second People's Hospital, Chengdu, Sichuan, China
| | - Li-Xin Fu
- Department of Dermatovenereology, Chengdu Second People's Hospital, Chengdu, Sichuan, China
| | - Wen-Ju Wang
- Department of Dermatovenereology, Chengdu Second People's Hospital, Chengdu, Sichuan, China
| | - Tao Chen
- Department of Dermatovenereology, Chengdu Second People's Hospital, Chengdu, Sichuan, China
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4
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Ibrahim AE, Magdy M, Khalaf EM, Mostafa A, Arafa A. Teledermatology in the time of COVID-19. Int J Clin Pract 2021; 75:e15000. [PMID: 34714575 PMCID: PMC8646275 DOI: 10.1111/ijcp.15000] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 09/20/2021] [Accepted: 10/27/2021] [Indexed: 12/11/2022] Open
Abstract
AIMS The enormous spread of the novel Corona virus disease (COVID-19) represents a challenge to dermatological practice. Accumulating evidence has suggested a possible role of teledermatology in facing this challenge. In this article, we aimed to give a general overview of teledermatology in terms of models of practice, modes of delivery, advantages, limitations, ethical considerations and legislative challenges as well as discussing, using examples from literature, how dermatological practice can benefit from teledermatology during the time of the COVID-19 pandemic. DISCUSSION AND CONCLUSION Teledermatology could be an accessible, accurate and cost-effective substitute for conventional face-to-face dermatological consultations during the COVID-19 pandemic. However, teledermatology practice needs updated legislation and guidelines. More efforts should be done to encourage dermatologists, especially in underserved communities, to provide teledermatology services. Ethical issues and data security related to teledermatology have to be considered.
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Affiliation(s)
- Ahmed Elsayed Ibrahim
- Department of NeuropsychiatryFaculty of MedicineAlexandria UniversityAlexandriaEgypt
| | - Mayar Magdy
- Barnet HospitalThe Royal Free London NHS Foundation TrustLondonUK
| | - Eslam M. Khalaf
- Department of Critical MedicineFaculty of MedicineAlexandria UniversityAlexandriaEgypt
| | - Alshimaa Mostafa
- Department of DermatologyGraduate School of MedicineKyoto UniversityKyotoJapan
- Department of DermatologyFaculty of MedicineBeni‐Suef UniversityBeni‐SuefEgypt
| | - Ahmed Arafa
- Department of Public HealthGraduate School of MedicineOsaka UniversitySuitaJapan
- Department of Public HealthFaculty of MedicineBeni‐Suef UniversityBeni‐SuefEgypt
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Abstract
The emergence of the coronavirus disease 2019 pandemic has led to a change in the whole world order. The key actors and occupational groups most at risk during this period have been health care professionals. In this pandemic, we, as dermatologists, also have many responsibilities regarding patients, ourselves, and society. Dermatologists have to protect themselves, their families, and their patients while working in pandemic services and outpatient clinics, as well as in their practices. One of their roles is to inform the public about protective measures for cutaneous side effects associated with the intensive use of disinfectants and long-term use of masks. In hospitals, only emergency patients had been admitted for treatment in all units during the pandemic, and elective operations and procedures were delayed. In this context, it is very important to determine what procedures will be carried out during this period in the follow up and treatment of chronic dermatologic diseases, as well as what interventional and cosmetic procedures may performed. Guidelines issued by various medical societies have made valuable contributions. The benefits and associated issues of teledermatology have pros and cons. Finally, one of the issues to ponder in the long term seems to be how we should pursue online education.
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Affiliation(s)
- Ayse Serap Karadag
- Department of Dermatology, Ataşehir Memorial Hospital, Istanbul, Turkey.
| | - Melek Aslan Kayıran
- Department of Dermatology, Istanbul Medeniyet University, School of Medicine, Goztepe Prof Dr Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Uwe Wollina
- Department of Dermatology and Allergology, Städtisches Klinikum Dresden Academic Teaching Hospital of the Technical University, Freidrichstrasse, Dresden, Germany
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6
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Chuh A, Zawar V, Fölster-Holst R, Sciallis G, Rosemann T. Twenty-five practical recommendations in primary care dermoscopy. J Prim Health Care 2021; 12:10-20. [PMID: 32223845 DOI: 10.1071/hc19057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 11/22/2019] [Indexed: 12/30/2022] Open
Abstract
Dermoscopy in primary care enhances clinical diagnoses and allows for risk stratifications. We have compiled 25 recommendations from our experience of dermoscopy in a wide range of clinical settings. The aim of this study is to enhance the application of dermoscopy by primary care clinicians. For primary care physicians commencing dermoscopy, we recommend understanding the aims of dermoscopy, having adequate training, purchasing dermoscopes with polarised and unpolarised views, performing regular maintenance on the equipment, seeking consent, applying contact and close non-contact dermoscopy, maintaining sterility, knowing one algorithm well and learning the rules for special regions such as the face, acral regions and nails. For clinicians already applying dermoscopy, we recommend establishing a platform for storing and retrieving clinical and dermoscopic images; shooting as uncompressed files; applying high magnifications and in-camera improvisations; explaining dermoscopic images to patients and their families; applying toggling; applying scopes with small probes for obscured lesions and lesions in body creases; applying far, non-contact dermoscopy; performing skin manipulations before and during dermoscopy; practising selective dermoscopy if experienced enough; and being aware of compound lesions. For clinicians in academic practice for whom dermatology and dermoscopy are special interests, we recommend acquiring the best hardware available with separate setups for clinical photography and dermoscopy; obtaining oral or written consent from patients for taking and publishing recognisable images; applying extremely high magnifications in search of novel dermoscopic features that are clinically important; applying dermoscopy immediately after local anaesthesia; and further augmenting images to incorporate messages beyond words to readers.
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Affiliation(s)
- Antonio Chuh
- Department of Family Medicine and Primary Care, The University of Hong Kong and Queen Mary Hospital, Pokfulam, Hong Kong; and JC School of Public Health and Primary Care, The Chinese University of Hong Kong and Prince of Wales Hospital, Shatin, Hong Kong; and The Hong Kong Society of Primary Care Dermoscopy, Hong Kong; and Corresponding author.
| | - Vijay Zawar
- The Hong Kong Society of Primary Care Dermoscopy, Hong Kong; and Department of Dermatology, Godavari Foundation Medical College and Research Center, Dr Vasantrao Pawar Medical College, Nashik, India
| | - Regina Fölster-Holst
- The Hong Kong Society of Primary Care Dermoscopy, Hong Kong; and Universitätsklinikum Schleswig-Holstein, Campus Kiel, Dermatologie, Venerologie und Allergologie, Germany
| | - Gabriel Sciallis
- The Hong Kong Society of Primary Care Dermoscopy, Hong Kong; and Emeritus, Department of Dermatology, Mayo Medical School, Minnesota, USA
| | - Thomas Rosemann
- The Hong Kong Society of Primary Care Dermoscopy, Hong Kong; and Institute of Primary Care, University of Zürich, Zurich, Switzerland
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Rouai M, Litaiem N, Hammami H, Bacha T, Jones M, Ksontini M, Rammeh S, Mokni M, Zeglaoui F. Dermoscopic features of mucosal lichen planus. Int J Dermatol 2021; 60:1368-1372. [PMID: 34081330 DOI: 10.1111/ijd.15683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/19/2021] [Accepted: 05/03/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Lichen planus (LP) is a chronic inflammatory dermatosis that affects the skin and the mucous membranes. The literature on the dermoscopic aspects of mucosal LP is still scarce. This study aimed to describe the dermoscopic aspects of mucosal LP and to provide a comprehensive updated summary of the literature. METHODS This was a cross-sectional, multicenter study conducted in Charles Nicolle, La Rabta, and Habib Thameur hospitals from December 2019 to October 2020. We included patients with histologically confirmed mucosal LP for whom a dermoscopic examination was performed. RESULTS Twenty-seven patients were enrolled. The main dermoscopic structures observed were as follows: Wickham's striae (WS) (91%), vessels (88%), pigmentated structures (41%), erosions (63%), scales (34%), and blunting of lingual papillae (3.1%). WS patterns were as follows: reticular (67%), radial (48%), annular (30%), globular (15%), dotted/starry sky (15%), and veil-like blue or grey-white homogenous pattern (19%). Vascular structures were as follows: linear (85%), dotted (70%), looped (22%), and peripheral sea anemone-like vessels (37%). These vessels were distributed in a radial arrangement at the periphery of the lesions in 67% of the cases. Pigmented structures included brown/blue globules (33%), grey-blue dots (30%), and brown dots (26%). CONCLUSION Dermoscopic features of mucosal LP are varied. WS is the hallmark of LP. The distribution and aspects of WS in mucosal LP were slightly different from those described in cutaneous LP. Physicians should be aware of these dermoscopic features that could help differentiate LP from other mucosal inflammatory diseases.
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Affiliation(s)
- Meriem Rouai
- Department of Dermatology, Charles Nicolle Hospital, Tunis, Tunisia.,Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Noureddine Litaiem
- Department of Dermatology, Charles Nicolle Hospital, Tunis, Tunisia.,Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Houda Hammami
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.,Department of Dermatology, Habib Thameur Hospital, Tunis, Tunisia
| | - Takwa Bacha
- Department of Dermatology, Charles Nicolle Hospital, Tunis, Tunisia.,Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Meriem Jones
- Department of Dermatology, Charles Nicolle Hospital, Tunis, Tunisia.,Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Meriem Ksontini
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.,Department of Pathology, Charles Nicolle Hospital, Tunis, Tunisia
| | - Soumaya Rammeh
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.,Department of Pathology, Charles Nicolle Hospital, Tunis, Tunisia
| | - Mourad Mokni
- Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.,Department of Dermatology, La Rabta Hospital, Tunis, Tunisia
| | - Faten Zeglaoui
- Department of Dermatology, Charles Nicolle Hospital, Tunis, Tunisia.,Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
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8
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Sonthalia S, Agrawal M, Bhatia J, Zeeshan M, Elsamanoudy S, Tiwary P, Bhat YJ, Jha A, Bosseila M. Entodermoscopy Update: A Contemporary Review on Dermoscopy of Cutaneous Infections and Infestations. Indian Dermatol Online J 2021; 12:220-236. [PMID: 33959518 PMCID: PMC8088165 DOI: 10.4103/idoj.idoj_559_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 10/16/2020] [Accepted: 12/20/2020] [Indexed: 01/11/2023] Open
Abstract
Infectious cutaneous diseases are very common, especially in certain geographic and tropical regions. Sometimes they may simulate other dermatoses, ordering verification of diagnosis with particular investigations. Dermoscopy is among one of the most important tools readily available in the outpatient setting for the dermatologist to confirm the diagnosis. In this up-to date review, literature concerning the various dermoscopic features of parasitic, viral, dermatophytic and bacterial cutaneous infections is composed. In addition artefacts as well as practical issues in dermoscopy usage are discussed; with the aim to empower dermatologists to promptly and non-invasively diagnose and manage cutaneous infections and infestations.
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Affiliation(s)
| | - Mahima Agrawal
- Department of Dermatology and STD, Lady Hardinge Medical College and ASS Hospitals, New Delhi, India
| | | | - Md Zeeshan
- Department of Skin and V.D., Patna Medical College and Hospital, Patna, Bihar, India
| | - Solwan Elsamanoudy
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Pankaj Tiwary
- Department of Skin and V.D., Patna Medical College and Hospital, Patna, Bihar, India
| | - Yasmeen Jabeen Bhat
- Department of Dermatology, Venereology & Leprosy, Government Medical College, Srinagar, J&K, India
| | - Abhijeet Jha
- Department of Skin and V.D., Patna Medical College and Hospital, Patna, Bihar, India
| | - Manal Bosseila
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt
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9
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AlJasser MI. A Practical Method to Prevent Cross-Infection When Performing Dermoscopy. Dermatol Pract Concept 2021; 11:e2021110. [PMID: 33614207 DOI: 10.5826/dpc.1101a110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2020] [Indexed: 10/31/2022] Open
Affiliation(s)
- Mohammed I AlJasser
- Division of Dermatology, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdulla International Medical Research Center, Riyadh, Saudi Arabia
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10
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Sheriff T, Murrell OGC, Murrell DF. Restructuring an academic dermatology practice during the COVID-19 pandemic. Dermatol Ther 2020; 33:e13684. [PMID: 32458551 PMCID: PMC7283657 DOI: 10.1111/dth.13684] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 05/24/2020] [Indexed: 11/29/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 is a highly virulent positive‐sense single stranded RNA virus that spreads rapidly via respiratory droplets, causing severe acute respiratory syndromes with significant mortality and morbidity. Currently 210 countries and territories are affected around the world with a reported 2.6 million confirmed cases. The coronavirus disease 2019 pandemic has changed the way patients attend their specialist appointments and receive medical care. While some specialist clinics have closed we have implemented strategies and restructured our academic practice in Australia to minimize the spread of disease while treating patients who need urgent care. We hope to share these strategies in the hope they may be useful to the dermatology community.
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Affiliation(s)
- Tabrez Sheriff
- Department of Dermatology, St George Hospital, Sydney, New South Wales, Australia.,University of New South Wales (UNSW), Sydney, New South Wales, Australia
| | - Oliver G C Murrell
- Department of Dermatology, St George Hospital, Sydney, New South Wales, Australia
| | - Dédée F Murrell
- Department of Dermatology, St George Hospital, Sydney, New South Wales, Australia.,University of New South Wales (UNSW), Sydney, New South Wales, Australia
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Jakhar D, Bhat YJ, Chatterjee M, Keshavmurthy V, Ankad BS, Jha AK, Jayasree P, Save S, Mukherjee SS, Mehta H, Udare S, Beergouder S. Dermoscopy Practice during COVID-19 Pandemic: Recommendations by SIG Dermoscopy (IADVL Academy). Indian Dermatol Online J 2020; 11:343-344. [PMID: 32695690 PMCID: PMC7367558 DOI: 10.4103/idoj.idoj_231_20] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 04/14/2020] [Accepted: 04/14/2020] [Indexed: 11/08/2022] Open
Affiliation(s)
- Deepak Jakhar
- Department of Dermatology, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, New Delhi, India
| | - Yasmeen J Bhat
- Department of Dermatology, Venereology and Leprosy, GMC, Jammu and Kashmir, India
| | - Manas Chatterjee
- Department of Dermatology, Command Hospital (Eastern Command), Kolkata, West Bengal, India
| | - Vinay Keshavmurthy
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Balachandra S Ankad
- Department of Dermatology, S Nijaligappa Medical College, Bengaluru, Karnataka, India
| | - Abhijeet K Jha
- Department of Skin and VD, Patna Medical College, Patna, Bihar, India
| | | | | | - Samipa S Mukherjee
- Consultant Pediatric Dermatologist and Dermatologist, Department of Dermatology, Cloudine Hospitals, Bengaluru, Karnataka, India
| | - Hita Mehta
- Department of Dermatology, Government Medical College, Bhavnagar, Gujrat, India
| | - Satish Udare
- Dr Udare Skin Clinic, Navi Mumbai, Maharashtra, India
| | - Savitha Beergouder
- Consultant Dermatologist, Anagha Skin Care Clinic, Bagalkot, Karnataka, India
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12
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Jakhar D, Kaur I, Kaul S. Art of performing dermoscopy during the times of coronavirus disease (COVID-19): simple change in approach can save the day! J Eur Acad Dermatol Venereol 2020; 34:e242-e244. [PMID: 32223004 DOI: 10.1111/jdv.16412] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- D Jakhar
- Department of Dermatology, North Delhi Municipal Corporation Medical College & Hindu Rao Hospital, New Delhi, India
| | - I Kaur
- Department of Dermatology, North Delhi Municipal Corporation Medical College & Hindu Rao Hospital, New Delhi, India
| | - S Kaul
- Department of internal Medicine, John H Stroger Hospital of Cook County, Chicago, IL, USA
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13
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Chuh A, Zawar V, Sciallis G, Fölster-Holst R. Outcomes of dermoscope-guided surgical procedures in primary care: case-control study. J Prim Health Care 2019; 11:54-63. [DOI: 10.1071/hc18064] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 12/30/2018] [Indexed: 11/23/2022] Open
Abstract
ABSTRACT
INTRODUCTION
No research has been found regarding outcomes of dermoscope-guided surgical procedures in primary care.
AIM
To establish whether outcomes of dermoscope-guided procedures performed in primary care settings differ from outcomes for similar procedures, performed without the use of a dermoscope.
METHODS
A retrospective case-control study design was used. All records of dermoscope-guided procedures performed over a 6-month period were retrieved. For each study procedure, the record of the most recent control procedure without dermoscopy guidance performed on a sex-and-age matched patient was retrieved from before we began performing dermoscope-guided procedures. Primary outcomes were: local inflammation and infections within 2 weeks’ post procedure; relapse in 6 months; and obvious scars in 6 months. Pain affecting activities of daily living in the first week after the procedure was the secondary outcome.
RESULTS
Records of 39 dermoscope-guided procedures and 39 control procedures were retrieved. No significant difference in local inflammation and infections in 2 weeks was found; relapse in 6 months after the study procedures was significantly lower for dermoscope-guided than control procedures (risk ratio (RR): 0.22; 95% confidence interval (CI): 0.05–0.95), and there were fewer obvious scars for dermoscope-guided procedures than control procedures (RR: 0.52; 95% CI: 0.32–0.83), with the number of small lesions (<4 mm) leaving scars in study procedures particularly less than that for control procedures (RR: 0.30; 95% CI: 0.13–0.67). There was no difference in the secondary outcome of pain affecting activities of daily living in the first week following the procedure.
CONCLUSION
In primary care, dermoscope-guided procedures achieved better outcomes than similar procedures without dermoscope guidance. Performing dermoscope-guided procedures in primary care might lower medical costs.
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