The Delivery Rates of Pathology Test Results to Patients: A Single-Center Experience in a Secondary Referral Center

BACKGROUND: Delivery of pathology reports to the patient is a key step in the biopsy pathway, which is important for patient safety in dermatology. Automated systems for facilitating such medical process began in 2010 in our hospital, sending short message service to scheduled patients. OBJECTIVE: The purpose of this study was to evaluate the delivery of pathology reports to patients and investigate factors that influence this process and annual trends. METHODS: We retrospectively reviewed the medical records of all outpatients (n=2,452) who underwent skin biopsy at our department of dermatology in 2009 and 2014. In each year group, we analyzed the proportion of revisiting patients in terms of year, sex, age, season, biopsy method and diagnosis. RESULTS: In 2009, a smaller proportion of patients (205; 91.5%) who had undergone shave or excisional biopsy than of those who had undergone punch biopsy returned (781; 98.0%; p<0.001). This trend was not significant in 2014. Whereas there was no significant difference of return visit ratio between men and women in 2009, a higher proportion of women (754; 98.0%) than men (633; 95.6%) re-visited after skin biopsy to confirm their diagnosis in 2014 (p=0.008). Three patients with either a malignant tumor or suspected malignant lesion that required complete excision did not return to our clinic. CONCLUSION: Pathology report delivery rates were fairly satisfactory, regardless of year, age, season, and diagnosis. Sex and biopsy method influenced the return visit ratio. More organized follow-up protocols are required to strengthen patient safety and prevent critical patient drop-out.

Metabolic syndrome amongst patients with psoriasis in a tertiary dermatology centre, Malaysia

Background: Psoriasis has been shown to be associated with a higher risk of metabolic syndrome and cardiovascular disease. Objective: To investigate the prevalence of metabolic syndrome among patients with psoriasis and study the association between psoriasis and cardiovascular risk factors. Methods: This was a hospital based case-control study conducted at the Dermatology Clinic, University Malaya Medical Centre (UMMC) from May 2010 to March 2011. A total of 131 adult patients with psoriasis and 129 age-, gender- and race-matched controls were recruited. All subjects answered a standardised cardiovascular risks questionnaire and had anthropometric measurements recorded. Laboratory investigations included fasting glucose / lipid profile, erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), urine microalbumin:creatinine ratio and an electrocardiogram. The diagnosis of metabolic syndrome was made using the harmonised criteria for metabolic syndrome in South East Asians. Statistical analysis was performed using statistical processing software (SPSS-17). Results: Metabolic syndrome was significantly higher among patients with psoriasis (64.9% versus 51.9%) (p = 0.034). The presence of metabolic syndrome was associated with low high density lipoprotein (HDL) (p=0.002) and high triglyceride (TG) levels (p = 0.014). The prevalence of diabetes mellitus was also significantly higher among patients with psoriasis (46.6% versus 27.1%) (p = 0.001). Hypertension, ischaemic heart disease, low density lipoprotein (LDL) levels, smoking and obesity were not significantly higher among patients with psoriasis. Conclusion: Our results demonstrate an association between psoriasis and metabolic syndrome which was primarily due to diabetes mellitus and dyslipidaemia.

The Recognition of Skin Health and Diseases in Dermatologic Outpatients / 대한피부과학회지

BACKGROUND: Social interests and the prevalence of skin disease have increased rapidly along with social development and improvement of life quality. Information on skin diseases and aesthetics are available through the internet and mass media. However, there have been few studies on the value of this information and the treatment-seeking behavior of patients. OBJECTIVE: To evaluate the recognition of skin health and diseases in patients who visit dermatology clinics and to improve the role of dermatologists in the process. METHODS: From March, 2008, to April, 2008, 1901 patients were asked to complete a questionnaire in 62 dermatologic hospitals. The questions covered: purposes of visiting the clinic; duration of skin disease; treatment-seeking behavior; recognition of the prescribed medicine; compliance and common sense about representative skin problems. RESULTS: Patients visited the dermatologic clinic because of skin disease for 67.39% of patients, esthetic treatment in 22.88% of patients, and both in 9.73% of patients. For visits to a dermatology clinic for skin problems, 61.28% of patients visited a clinic but 38.72% did not. Most (81.38%) patients followed the doctor's prescription. Most negative responses to prescribed medicine were due to the internet and mass media or wrong information from pharmacists (52.24%). Moreover, patients who learned about skin diseases and prescription medicines through the internet usually lacked compliance and common sense regarding their skin problems. CONCLUSION: The internet can provide good information about healthy skin and skin diseases, but we have to consider its disadvantages of exaggeration and misbelief. The effects of this tool have been overstated and excessively publicized in comparison to actual established clinical results. Use of the internet may delay diagnosis and decrease compliance. Consequently, dermatologists have to provide correct information to minimize the disadvantages of internet information. Patients who have abnormal skin problems should visit dermatologic clinics to be evaluated and treated appropriately.