Primary care physicians trained in dermatoscopy can improve odds for early detection of melanoma while reducing the need for invasive biopsies, according to a study in The Journal of the American Osteopathic Association.
Researchers say non-dermatologist physicians can make earlier and more accurate diagnoses of melanomas using a dermatoscope. This would be particularly beneficial for patients who lack access to dermatologists, the authors noted, because primary care physicians typically biopsy suspicious spots or refer patients to a specialist.
The training is available in different formats and physicians can hone their skills quickly with regular practice. The best way to improve proficiency is by incorporating thorough skin exams in patients' annual checkups."
Natalia Jaimes, MD, a dermatologist and lead author on this study
Melanoma is the fifth most common cancer in the U.S. and kills more than 9,000 people each year. Dr. Jaimes says that number could be significantly lowered with more widespread early detection in communities without access to specialized care.
"If detect early, Melanoma is a highly treatable disease, yet so many people die from it," she says. "The good news is the solution is relatively inexpensive."
Dermatoscopes are inexpensive instruments, costing as little as $500, that provide ×10 magni?cation and illuminate the skin in a manner that minimizes light rejection off the skin surface. Researchers say diagnosis of specific melanomas using a dermatoscope is four times more accurate than when done with an unaided eye.
Adequate training on dermatoscopy is available in a one- or two-day course but can be as minimal as a 12-hour online program. Physicians who cannot accurately differentiate benign nevi from a malignant melanoma must rely on biopsies to make the diagnosis. Having more physicians trained in dermatoscopy would reduce the costs associated with those medical procedures as well as patient discomfort.
Dr. Jaimes says physicians trained in dermatoscopy can improve odds for early detection of melanoma, which is crucial for patients' prognoses and survival rates. Most melanomas discovered in Stage 0 or Stage 1 can be easily removed with no need for further treatment. The survival rate at this stage is around 98%.
James, N. et al. (2019) Dermoscopy: A Review of the Structures That Facilitate Melanoma Detection. The Journal of the American Osteopathic Association. doi.org/10.7556/jaoa.2019.067.