A survey-based study of management of longitudinal melanonychia amongst attending and resident dermatologists

Halteh, Pierre; Scher, Richard K.; Artis, Amanda; Lipner, Shari R.

doi:10.1016/j.jaad.2016.11.053

Cited by 10 publications

(10 citation statements)

References 3 publications

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“…Limitations of the mnemonic include lack of validation in a clinical setting, the inclusion of clinical and demographic variables that may not be practical for the diagnosis of SUM, and the limited use among dermatologists in the United States (range of dermatologists, 12%-32%). 12 The optimal management of SUM includes early diagnosis and complete surgical excision. 13 Although dermoscopy is not a replacement for histopathologic diagnosis, 14,15 the detailed examination of magnified morphologic patterns of the nail unit may aid physicians in the detection of SUM.…”

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confidence: 99%

Assessment of a Predictive Scoring Model for Dermoscopy of Subungual Melanoma In Situ

Ohn

Cho

et al. 2018

JAMA Dermatol

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IMPORTANCE Subungual melanoma in situ (SMIS) is a malignant neoplasm that requires early diagnosis and complete surgical excision; however, little is known about the usefulness of the detailed dermoscopic features of longitudinal melanonychia (LM) to predict the diagnosis of SMIS. OBJECTIVES To investigate the characteristic dermoscopic findings of SMIS and to establish a predictive scoring model for the diagnosis of SMIS in patients with adult-onset LM affecting a single digit.

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confidence: 99%

Assessment of a Predictive Scoring Model for Dermoscopy of Subungual Melanoma In Situ

Ohn

Cho

et al. 2018

JAMA Dermatol

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“…In a survey-based study of 240 dermatology residents, only 10% performed more than 10 nail procedures, while 58% performed 10 or fewer nail procedures .38 In another survey-based study, 62% (88/142) of dermatology residents were not confident diagnosing and managing patients with melanonychia. 38,39 In addition, the low reimbursement rate for a nail biopsy ($64.20) may be a deterrent to dermatologists performing the procedure. There was no statistically significant difference between nail and skin biopsy reimbursements (t = 0.38, P = .69) and nail biopsies require more resources and take much more time to perform.…”

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confidence: 99%

Retrospective analysis of nail biopsies performed using the Medicare Provider Utilization and Payment Database 2012 to 2017

Wang

Lipner

2021

Dermatologic Therapy

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Subungual melanoma (SUM) is subset of acral melanoma that develops within the nail unit and is associated with a poor prognosis. Nail biopsy is the only way to definitively diagnosis SUM. Our objectives were to analyze the Medicare database for nail biopsy utilization and to compare the annual nail biopsy rate with the estimated incidence of SUM in the United States. A retrospective study on nail biopsy data was performed using the Medicare Provider Utilization and Payment Database 2012 to 2017. The number of nail biopsies performed per 100 000 people was compared to SUM incidence per 100 000 people. Podiatrists, dermatologists, other physicians, and NP/PAs respectively performed 12.12, 0.42, 0.08, 0.07 nail biopsies per 100 000 people annually. Dermatologists performed adequate nail biopsies to cover the minimum (0.7%), but not the maximum (3.5%) estimated incidence of SUM. Only 0.28% and 1.01% of general dermatologists and Mohs surgeons, respectively, performed nail biopsies in 19/50 (38.00%) states and 69/929 (7.42%) zip codes. Limitations of our study were that nail biopsies on patients less than 65 years, and those with no or commercial health insurance were not analyzed. In sum, very few dermatologists performed nail biopsies in the Medicare database. Increased efforts are needed to educate dermatologists on nail surgery.

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“…Clinical evaluation using the ABCDEF rule proposed by Levit et al in 2000 10 can guide the differential diagnosis; however, fewer than half of the practitioners were familiar with this mnemonic, and a previous study showed low sensitivity of diagnosis associated with this rule. 11,12 In addition to clinical assessment, onychoscopy has become an additional tool to provide a provisional diagnosis. However, limited studies on onychoscopic findings among malignant and benign melanocytic conditions have been published.…”

Section: Introductionmentioning

confidence: 99%

<p>Clinical and Onychoscopic Features of Benign and Malignant Conditions in Longitudinal Melanonychia in the Thai Population: A Comparative Analysis</p>

Kungvalpivat¹,

Rojhirunsakool²,

Chayavichitsilp³

et al. 2020

CCID

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A survey-based study of management of longitudinal melanonychia amongst attending and resident dermatologists

Cited by 10 publications

References 3 publications

Assessment of a Predictive Scoring Model for Dermoscopy of Subungual Melanoma In Situ

Assessment of a Predictive Scoring Model for Dermoscopy of Subungual Melanoma In Situ

Retrospective analysis of nail biopsies performed using the Medicare Provider Utilization and Payment Database 2012 to 2017

<p>Clinical and Onychoscopic Features of Benign and Malignant Conditions in Longitudinal Melanonychia in the Thai Population: A Comparative Analysis</p>

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