Dermoscopy improves GP management of melanoma

The correct use of readily available diagnostic devices can almost double the accuracy of general practitioners’ melanoma diagnoses and reduce unnecessary specialist referrals and skin lesion removal by about two-thirds, a study of Australian GPs has shown.

The study, "Dermoscopy and sequential imaging in primary care", led by Associate Professor Scott Menzies from the University of Sydney and the Sydney Melanoma Diagnostic Centre, finds suitably equipped primary care givers can effectively diagnose and monitor most patients with pigmented skin lesions (such as moles and melanoma). This reduces the need for expensive referrals and excisions.

Its findings have been published in the latest edition of the British Journal of Dermatology.

Sixty three Perth-based GPs were given two dermoscopy diagnostic instruments to use over nine months: a hand-held magnifying dermatoscope which highlights features of a lesion invisible to the naked eye; and a dermoscopy digital camera device, allowing clinicians to monitor changes in a lesion over time.

Participating GPs received training on how to use the two devices before incorporating them into their practices.

"Dermoscopy significantly reduced unnecessary excisions and referrals," Professor Menzies says. "During the study period, the number of benign lesions either excised or referred was 64 per cent fewer than if GPs had relied on naked eye examinations alone.

"The accuracy of melanoma diagnosis almost doubled, with 72 per cent of diagnoses proving accurate, compared to the 38 per cent accuracy rate of naked eye examinations.

"The use of dermoscopy at the primary healthcare level would make for more effective and efficient patient management," Professor Menzies says. "There would almost certainly be a cost benefit to using dermoscopy too, given the reduced number of lesion excisions."

(Source: University of Sydney: British Journal of Dermatology: September 2009)