Dermatoscopy in GP practice - challenge in the battle with melanoma

Elina Skuja, Valerija Novaka, Laine Bekere, Raimonds Karls, Ilze Skuja

Keywords: Dermatoscopy, skin pigmentation, melanoma

Background:

Incidence of skin melanoma varies across Europe ranging 3 - 35 patients per 100,000.
In Latvia, 230 (11.8/ 100,000) patients were newly diagnosed with skin melanoma in 2017.
This indicates the need for improving prevention and early diagnosis of disease.
Dermatoscopy in general practice (GP) provides an opportunity to diagnose melanoma at early and potentially curable stage and can be used as a first-line diagnostic tool for melanoma.
Skin pigmentation diagnostics with dermatoscope is a cost-effective manipulation of GP in Latvia. There are European co-financing projects available to support GPs in purchasing equipment.

Research questions:

To evaluate patients' risk factors for development of melanoma and to find out patients’ opinion on possible diagnostics of skin pigmentation in primary care (PC).
Compare the results of the skin pigmentation inspection using naked eye method and dermatoscopy in GP, evaluated by a dermatologist (2nd opinion).

Method:

The study includes adults from different GP practices in Latvia who agree to participate. Self drawn-up questionnaire is used, including questions about risk factors and knowledge. Likert scale is used to assess thoughts on dermatoscopy in PC settings.
At step 2 patients with skin pigmentations will be evaluated for 1-5 skin pigmentations using naked eye method and digital dermatoscope. Digital images obtained during dermatoscopy will be submitted to a dermatologist for independent evaluation to compare the results.
Data will be analysed using SPSS program.

Results:

Pre-liminary results show that patients have different opinion about melanoma. The attitude to GPs involvement differs from absolute trust to GP until trust only to dermatologist. Study also proved that patients support when GPs work with computerised additional features in making diagnoses.

Conclusions:

It is very helpful to work in everyday practice with digital medical tool to get quicker and more precise diagnoses. Usage of digital dermatoscopy could improve GPs everyday work with patients supposed to melanoma.

Points for discussion:

Is skin melanoma a problematic issue in other countries?

Do GPs evaluate skin pigmentations in other countries?

#98