Clinical ABCDE rule for early melanoma detection.

BACKGROUND: The ABCDE rule systematizes warning signs for malignant melanoma (MM). OBJECTIVES: To evaluate whether the ABCDE signs are associated with early detection of MM. MATERIALS & METHODS: Based on a retrospective study over 11.5 years, we assessed whether ABCDE signs are associated with early diagnosis of MM. RESULTS: In total, 144 MM were included; 52 (36.1%) in situ and 92 (63.9%) invasive lesions. For 23.6%, the MM were first suspected by an individual other than a dermatologist. The "E sign" was significantly less frequent among in situ lesions (32.7% versus 50.0%; p = 0.044). Based on adjusted analyses, the probability of MM being first suspected by a non-dermatologist consistently increased with the number of ABCDE signs of the lesion, ranging from 8% for a neoplasm with no ABCDE signs to 32% for a lesion with five signs (OR = 1.6; 95% CI: 1.2-2.2; p = 0.004). CONCLUSION: A higher number of ABCDE signs were associated with a greater chance of MM being first suspected by a non-dermatologist, but not in situ MM diagnosis. Relying on the ABCDE rule alone might result in missing early MM lesions.

Public Perception of Dermatologists: A Single Center Surveillance / 대한피부과학회지

BACKGROUND: Currently, physicians from different medical specialties treat patients' skin conditions, especially for cosmetic purposes. Although diagnosis and treatment made by non-dermatologists may sometimes be improper, many patients are unable to distinguish a non-dermatologist from a dermatologist. OBJECTIVE: The aim of this study was to evaluate public's perception of dermatologists. METHODS: A total of 515 participants completed the online survey. The questionnaire consisted of three main parts: information regarding respondents, experience of dermatological treatments, and awareness of skin treatments performed by dermatologists, and by medical specialties. RESULTS: Overall, 48% of respondents were unable to distinguish a dermatologist from a non-dermatologist; however, 93% of respondents responded that they were willing to visit a dermatologist for treatment. A fair number of respondents identified dermatologists by signboards, professional biographies, and licenses. However, some non-dermatologists' signboards and biographies were considered misleading and confused patients. CONCLUSION: Many patients intend to visit a dermatologist for their dermatological treatments. However, half could not distinguish dermatologists from non-dermatologists. For this reason, we underline the importance of increasing public awareness of the dermatologist's expertise in helping patients in choosing their clinics.

Seventy-four Complicated Cases Referred to a Tertiary Hospital in Korea after Dermatologic Procedures / 대한피부과학회지

BACKGROUND: During the last dozen years, tremendous changes have occurred in dermatologic care in Korea. Unlike in the past, dermatologic procedures, including cosmetic treatments, are now frequently carried out by non-dermatologists, oriental medicine doctors, dentists, or non-medical personnel. Procedure-related complications are increasing, but few studies have addressed this issue. OBJECTIVE: This study aims to analyze the scope of complicated cases after dermatologic procedures at Chonbuk National University Hospital. METHODS: This study analyzed the records of 74 patients with complications after dermatologic procedures that visited Chonbuk National University Hospital between January 2008 and December 2013. RESULTS: The numbers of complicated cases increased yearly. The ratio of male to female patients with complicated cases was 1:6.4, and the mean age was 44.4 years. The ratio of practitioners who treated the patients was 1u1. 6u5.7 dermatologists to non-medical personnel to non-dermatologists, and the majority of non-dermatologists who treated the patients were general practitioners. A total of 82.5% of the patients who visited non-dermatologists mistook them as dermatologists. The most common complication was a pigmentation change detected by non-dermatologists (n=21, 38.9%), and dermatologists (n=4, 44.4%). Foreign body granulomatous reactions were detected by non-medical personnel (n=12, 80.0%). Especially, laser ablations of undiagnosed skin cancer by non-dermatologists were seven times greater than dermatologist. CONCLUSION: Complications after dermatologic procedures are increasing and happen more commonly when patients are seen by non-dermatologists, including oriental medicine doctors, dentists, and non-medical personnel, than dermatologists. This study may help improve strategies for health-care safety management and quality in the dermatological field in Korea.