Outcomes of dermoscope-guided surgical procedures in primary care: case-control study
Antonio Chuh 1 2 6 , Vijay Zawar 3 , Gabriel Sciallis 4 , Regina Fölster-Holst 51 Department of Family Medicine and Primary Care, The University of Hong Kong and Queen Mary Hospital, Pokfulam, Hong Kong
2 Hong Kong Society of Primary Care Dermoscopy, Hong Kong
3 Department of Dermatology, Dr Vasantrao Pawar Medical College, Nashik, India
4 Department of Dermatology, Mayo Medical School, Minnesota, USA
5 Universitätsklinikum Schleswig-Holstein, Campus Kiel, Dermatologie, Venerologie und Allergologie, Germany
6 Corresponding author. Email: antonio.chuh@yahoo.com.hk
Journal of Primary Health Care 11(1) 54-63 https://doi.org/10.1071/HC18064
Published: 8 March 2019
Journal Compilation © Royal New Zealand College of General Practitioners 2019.
This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Abstract
INTRODUCTION: No research has been found regarding outcomes of dermoscope-guided surgical procedures in primary care.
AIM: To establish whether outcomes of dermoscope-guided procedures performed in primary care settings differ from outcomes for similar procedures, performed without the use of a dermoscope.
METHODS: A retrospective case-control study design was used. All records of dermoscope-guided procedures performed over a 6-month period were retrieved. For each study procedure, the record of the most recent control procedure without dermoscopy guidance performed on a sex-and-age matched patient was retrieved from before we began performing dermoscope-guided procedures. Primary outcomes were: local inflammation and infections within 2 weeks’ post procedure; relapse in 6 months; and obvious scars in 6 months. Pain affecting activities of daily living in the first week after the procedure was the secondary outcome.
RESULTS: Records of 39 dermoscope-guided procedures and 39 control procedures were retrieved. No significant difference in local inflammation and infections in 2 weeks was found; relapse in 6 months after the study procedures was significantly lower for dermoscope-guided than control procedures (risk ratio (RR): 0.22; 95% confidence interval (CI): 0.05–0.95), and there were fewer obvious scars for dermoscope-guided procedures than control procedures (RR: 0.52; 95% CI: 0.32–0.83), with the number of small lesions (<4 mm) leaving scars in study procedures particularly less than that for control procedures (RR: 0.30; 95% CI: 0.13–0.67). There was no difference in the secondary outcome of pain affecting activities of daily living in the first week following the procedure.
CONCLUSION: In primary care, dermoscope-guided procedures achieved better outcomes than similar procedures without dermoscope guidance. Performing dermoscope-guided procedures in primary care might lower medical costs.
KEYWORDS: Dermoscopy; general practice; laser procedures; primary health care; skin biopsy; skin microscopy
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