RESUMO
A retrospective audit of melanoma clinical diagnoses was undertaken for a group of 35 Australian dermatologists. This was compared with the histological diagnoses. In a 1-year period, 195 of the 686 clinically suspicious lesions were histologically confirmed as melanoma. Therefore, the number needed to treat for histological referrals for melanoma is four for this group of dermatologists. In addition, we found that the sensitivity for the diagnosis of melanoma was 89.1% if we consider all lesions that are possibly clinically suspicious of melanoma. Our results suggest that the clinical diagnosis of melanoma may not be difficult for lesions that are clinically characteristic.
Assuntos
Melanoma/diagnóstico , Dermatopatias/diagnóstico , Neoplasias Cutâneas/diagnóstico , Pele/patologia , Austrália , Biópsia , Dermatologia , Diagnóstico Diferencial , Erros de Diagnóstico , Humanos , Auditoria Médica , Estudos Retrospectivos , Sensibilidade e EspecificidadeRESUMO
A prospective study was conducted to assess general practitioners' diagnostic skills in a referral setting. The primary objective was to identify general practitioners' strengths and weaknesses in diagnosing a broad spectrum of skin conditions. The diagnoses of 315 skin conditions made by 165 general practitioners were compared with a reference standard. The reference standard was made up of 73 histopathological diagnoses, 119 dermatologists' clinical diagnoses and 123 dermatologists' diagnoses plus follow up. The diagnoses assigned by referring general practitioners were consistent with dermatologists' clinical diagnoses and histology (where available) in 57% of cases. General practitioners made the correct diagnosis in 44% of cases when compared with histopathology. General practitioners were generally good at diagnosing conditions such as acne, warts, rosacea, molluscum contagiosum, vitiligo and skin tags. The proportion of correct diagnoses for premalignant and malignant skin tumours was 47%, and that of skin rashes requiring a diagnosis was 44%. Further education of general practitioners would help to improve their diagnostic skills in certain skin conditions.
Assuntos
Competência Clínica/estatística & dados numéricos , Medicina de Família e Comunidade/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Encaminhamento e Consulta/estatística & dados numéricos , Dermatopatias/diagnóstico , Adulto , Feminino , Pesquisas sobre Atenção à Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , New South Wales , Estudos ProspectivosRESUMO
Multiple therapeutic options are available for treatment of Bowen's disease. The choice of therapy depends on clinical circumstance and medical practitioner experience. Newer therapies have more extensive support from the literature, but more established therapies may be preferred because of accessibility, cost and efficacy. An overview of the current therapeutic options for Bowen's disease is presented.
