Finding the Right Scope: Dermoscopy for Primary Care

Background • Primary care physicians (PCPs) frequently address skin concerns and perform clinical skin examinations1 • For PCPs, the use of dermoscopy has been shown to increase the sensitivity for skin cancer diagnosis compared to unassisted examinations2,3 • Prior to this study, no formal consensus existed on the fundamental knowledge and skills that PCPs should have with respect to dermoscopy Objectives • To develop an expert opinion consensus statement on 2 proficiency standards for PCPs using dermoscop

Mapping Melanoma Risk and Locating High-Need Regions for Dermoscopy and Skin Biopsy Training

Background- Dermoscopy and skin biopsy trainings have been shown to help improve PCPs’ knowledge of and confidence in detecting skin cancer. The goal of this project was to determine where to focus training efforts in order to maximize our impact and reach regions that face the highest burden of melanoma in the state

Pediatric Dermatology eConsult Program with Dermoscopy: Sub Analysis of Infantile Hemangiomas

Here we present an analysis of pediatric dermatology eConsults with emphasis on dermoscopy utilization and the impact on eConsult on infantile hemangiomas (IH) management

Impact of Dermoscopy Training for PCPs on NNB to Detect Melanoma

The goal of this project was to analyze the impact of dermoscopy training on the number of melanocytic nevi needed to biopsy (NNB) to detect a melanoma in the primary care setting

Total Body Photography and Sequential Digital Dermoscopy Imaging for Melanoma Surveillance in Patients Starting Natalizumab for Multiple Sclerosis

Introduction: Natalizumab is an integrin receptor antagonist that has been approved by the Food and Drug Administration to treat multiple sclerosis and Crohn’s disease. The drug has been linked to an increased risk of melanoma. This brief report highlights an innovative clinical approach for monitoring the skin of patients prescribed natalizumab. Methods: We include 2 cases from our skin oncology clinic and a literature review on the incidence of melanoma in patients prescribed natalizumab between 2004 and 2019. Results: In addition to our 2 cases, we found 193 reports of patients with melanoma who were prescribed natalizumab. We propose an innovative and proactive approach using total body photography and sequential digital dermoscopy imaging before starting and while treating patients with natalizumab. Discussion: Given the mechanism of action of natalizumab, many of the melanomas diagnosed likely arose from preexisting melanocytic nevi. Using total body photography before starting this high-risk medication and then sequential digital dermoscopy imaging will increase a dermatologist’s ability to recognize new and preexisting skin lesions that have evolved since the patient began taking natalizumab. Conclusions: Using the latest non-invasive technology to detect skin cancer supports systematic and objective monitoring of changing melanocytic growths in patients prescribed natalizumab, resulting in earlier detection of melanoma and greater cure rates

Geographic Distribution of Melanoma Cases in Maine: Identifying Vulnerable Counties for Targeted Intervention

Introduction: Maine has the twelfth highest incidence of melanoma in the United States. The purpose of this study was to determine which Maine counties were the most impacted by melanoma through the use of geographical methods. Identification of counties with the highest prevalence of melanoma will help in targeting future training and public health interventions. Methods: All melanoma cases (n=5,340) reported to the Maine CDC Cancer Registry from 2013 to 2018 were sorted by pathologic T stage. Data were sorted by county and population-adjusted. Population data and provider data came from Area Health Resource Files. County and zip-code maps were constructed to highlight which counties have the greatest burden of melanoma in the state. Results: Hancock, Knox, Sagadahoc, and Washington counties had the highest rates of late-stage melanoma cases when adjusting for age and population. Conclusions: Through the use of geospatial methods, counties with the highest rates of late-stage melanoma were able to be identified. Particular counties of note include Hancock, Knox, Sagadahoc, and Washington. These counties were found to have the greatest need and can serve as a launch point for targeted public health interventions

Erythema Ab Igne due to Heating Pad Use: A Case Report and Review of Clinical Presentation, Prevention, and Complications

Erythema ab igne is an asymptomatic cutaneous condition caused by exposure to heat. Cases of erythema ab igne may prove to be diagnostically challenging due to lack of familiarity with the condition. While this dermatosis carries a favorable prognosis, nonmelanoma skin cancers have been reported to arise within lesions of erythema ab igne. Erythema ab igne is preventable, and, thus, clinicians should provide education regarding safe use of heating devices to patients using these products in both outpatient and inpatient settings

Theory-Based Approaches to Support Dermoscopic Image Interpretation Education: A Review of the Literature

Introduction: Efficient interpretation of dermoscopic images relies on pattern recognition, and the development of expert-level proficiency typically requires extensive training and years of practice. While traditional methods of transferring knowledge have proven effective, technological advances may significantly improve upon these strategies and better equip dermoscopy learners with the pattern recognition skills required for real-world practice. Objectives: A narrative review of the literature was performed to explore emerging directions in medical image interpretation education that may enhance dermoscopy education. This article represents the first of a two-part review series on this topic. Methods: To promote innovation in dermoscopy education, the International Skin Imaging Collaboration (ISIC)assembled a 12-member Education Working Group that comprises international dermoscopy experts and educational scientists. Based on a preliminary literature review and their experiences as educators, the group developed and refined a list of innovative approaches through multiple rounds of discussion and feedback. For each approach, literature searches were performed for relevant articles. Results: Through a consensus-based approach, the group identified a number of emerging directions in image interpretation education. The following theory-based approaches will be discussed in this first part: whole-task learning, microlearning, perceptual learning, and adaptive learning. Conclusions: Compared to traditional methods, these theory-based approaches may enhance dermoscopy education by making learning more engaging and interactive and reducing the amount of time required to develop expert-level pattern recognition skills. Further exploration is needed to determine how these approaches can be seamlessly and successfully integrated to optimize dermoscopy education