Clinical and Educational Gaps in Diagnosis of Nail Disorders

Hare, Anna Q.; Rich, Phoebe

doi:10.1016/j.det.2016.02.002

Cited by 16 publications

(20 citation statements)

References 7 publications

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“…The collaborative planning of the lectures may have enabled the participants to attain better and detailed understanding of the nail disease processes that require surgery. Sufficient knowledge of nail anatomy and pathology leads to safety and efficacy of nail surgery and comprehension of the clinical features of the nail diseases [2,10]. For example, knowing the anatomical location of the lateral nail matrix horns is crucial when performing chemical matricectomy as shown in Figure 1 to prevent recurrence of ingrown nails [11].…”

Section: Discussionmentioning

confidence: 99%

Integrated Cadaveric Nail Surgery Course Improves Self-Assessed Knowledge and Competency of Dermatologists

Solak

Karakaş

Sindel

et al. 2021

Skin Appendage Disord

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Introduction: Dermatologists see many patients with nail disorders requiring surgical interventions. However, nail surgery is often found to be difficult by dermatologists. The aim of this study was to evaluate the effectiveness of an integrated nail surgery course. Methods: A nail surgery course model, combining anatomy, pathology, and dermatology with theoretical lectures and hands-on training on fresh-frozen cadaver, was designed for dermatologists. Before and after the course, the participants were asked to complete a questionnaire in which they assessed their knowledge and competence levels. Results: Twenty-eight dermatologists completed the questionnaires. The majority of the dermatologists (79.6%) had limited nail surgery experience, previously. The most commonly cited reasons for lack of knowledge or low or moderate theoretical and/or practical level of knowledge of nail surgery were not having received theoretical and practical education during dermatology residency. The median scores of self-assessed knowledge and competency improved significantly after the course (p < 0.001). The majority (82.1%) of the participants were “quite” or “very” well satisfied. Conclusion: An integrative nail surgery course model seems beneficial and encouraging for dermatologists. Organizing this type of nail surgery course, especially in medical schools using fresh-frozen cadavers, may significantly improve dermatologists’ knowledge and skills.

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Section: Discussionmentioning

confidence: 99%

Integrated Cadaveric Nail Surgery Course Improves Self-Assessed Knowledge and Competency of Dermatologists

Solak

Karakaş

Sindel

et al. 2021

Skin Appendage Disord

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“…Whether a primary-care physician is comfortable diagnosing onychomycosis and ruling out serious differential diagnoses such as psoriasis and melanoma is beyond the scope of the present study. With the findings in Dermatologic Clinics by Hare and Rich 13 suggesting that dermatology residents are undertrained regarding diagnosis of nail dystrophy, there is concern that cases of onychomycosis and other conditions may be overlooked by even specialized medical providers.…”

Section: Discussionmentioning

confidence: 99%

“…In a survey of third-year dermatology residents by Lee et al 12 in the Journal of the American Academy of Dermatology in 2011, 58% of respondents had performed fewer than ten nail procedures, and 30% felt that they were not ''competent'' in nail surgery thus far in residency. Furthermore, Hare and Rich, 13 in Dermatologic Clinics in 2016, stated that ''[r]esidents are often not taught how to work up a nail dystrophy to arrive at a differential diagnosis based on history and clinical nail morphology.'' These findings suggest that dermatologists-specialists in hair, skin, and nails-may not be adequately prepared to evaluate and treat nail disease.…”

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confidence: 99%

Perceptions Surrounding Onychomycosis in the Health Professions Student Population: The Disease, Treatments, and Quality of Life

Martucci¹,

Vlahovic²

2020

Journal of the American Podiatric Medical Association

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Background Discolored toenails is a common complaint presented to podiatric physicians, dermatologists, and primary-care physicians. Although various local and systemic conditions influence changes in nails, nearly 50% is due to fungal infections. We surveyed the health professions student population to gain insight into how future medical professionals may approach this condition and to explore perceptions of onychomycosis, treatments, and effects on quality of life. Methods The primary outcome measure was a self-reported online Google Forms survey developed by the authors and sent to podiatric, allopathic, and osteopathic medical students and nursing students in Philadelphia, Pennsylvania. Results Of the 245 respondents, 92% agreed that toenail fungus is both a health and a cosmetic concern. Seventy-seven percent of respondents said “yes” when asked if they would seek treatment, and 67% would wait 1 month to 1 year to see a medical professional. When seeking treatment, 57% reported that they would see a primary-care physician initially, and 27% and 5% would seek care from a podiatric physician or dermatologist, respectively. A total of 91% would spend up to $300 annually for treatment, with only 4% willing to spend more than $500 per year. Respondents' greatest concern would be physical appearance. Conclusions Although agreement exists among the health professions students surveyed that toenail fungus presents both a cosmetic and a health concern, inconsistencies regarding time to treatment, treating professional, and effects on quality of life persist. It is not reasonable for all medical professionals to effectively recognize and treat nail disease, but it is paramount that patients are directed to medical professionals who can accurately exclude other conditions to alleviate social and financial burdens patients may face due to onychomycosis.

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“… 2 We hypothesized that Twitter may be a useful way to expand access to dermatology education to other specialties and allied health care professionals. Given the established educational gaps in the diagnosis and management of nail conditions, 3 we explored Twitter as a medium for nail education.…”

mentioning

confidence: 99%

“…Even dermatology residents may receive limited exposure to nail diseases. 3 In addition, tweetorials may be considered a form of digital scholarship, and some call for the inclusion of such materials for academic promotion, similar to a published article. 4 Twitter offers a promising global frontier for expanding access to nail education, and tweetorials offer an uncommon and interactive method to carry out such education.…”

mentioning

confidence: 99%