Vol 17, No 2 (2021)
Research paper
Published online: 2020-11-13

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Access to a dermatoscope during dermatology courses motivates students’ towards thorough skin examination

Magdalena Chrabąszcz, Cezary Maciejewski, Teresa Wolniewicz, Rosanna Alda-Malicka, Patrycja Gajda, Joanna Czuwara, Lidia Rudnicka
Oncol Clin Pract 2021;17(2):47-52.


Introduction. Dermatoscope is a tool for a skin examination, used especially in early detection of malignant skin lesions. Non-dermatologists are being trained for opportunistic melanoma detection with the usage of dermatoscopy, however, still non-satisfactory. This study was aimed to determine whether practical dermoscopy adjunct to traditional, lecture and seminar-based medical school curriculum would improve the perceived relevance of regular skin examination and basic skin lesions differentiation.

Material and method. Fourth-year medical students participating in a 3-week-long dermatology course were randomly assigned to two groups: the first one called A with limited access to a dermatoscope and the second one called B, with unlimited access to dermatoscopes throughout the course. All participants answered surveys concerning their attitude towards skin examination, with a rating scale from 1 to 5, before and after the course. Also, all participants completed an image-based dermoscopy test for distinguishing benign from malignant skin lesions.

Results. Students assigned to group B significantly improved their perceived importance of routine skin examination (mean scores before 4.38; after 4.57, P = 0.03). No such tendency was observed in group A — before 4.40, after 4.49 (P = 0.29). Students in the group with higher dermatoscope availability considered buying a dermatoscope more often (61%) than those without (44%) (P = 0.037). No significant score difference was observed when testing skin lesions identification, mean for extended access 7.84 vs. normal 7.64 points (P = 0.69).

Conclusions. Higher availability of dermatoscopy during dermatology rotations may encourage students to use this tool in future clinical practice and improve early detection of malignant skin lesions.

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  1. Rogers HW, Weinstock MA, Feldman SR, et al. ncidence estimate of nonmelanoma skin cancer (keratinocyte carcinomas) in the U.S. population, 2012. JAMA Dermatol. 2015; 151(10): 1081–1086.
  2. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin. 2018; 68(1): 7–30.
  3. Bickers D, Lim H, Margolis D, et al. The burden of skin diseases: 2004 a joint project of the American Academy of Dermatology Association and the Society for Investigative Dermatology. J Am Acad Dermatol. 2006; 55(3): 490–500.
  4. Allemani C, Matsuda T, Di Carlo V, et al. Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet. 2018; 391(10125): 1023–1075.
  5. Forsea AM. Melanoma Epidemiology and Early Detection in Europe: Diversity and Disparities. Dermatol Pract Concept. 2020; 10(3): e2020033.
  6. %A, P.R.A.P.J.W.A.A.N.-G.A.J.F.A.E.K.-W.A.T.Ś.A.A.J.A.M.S., Cutaneous melanoma — diagnostic and therapeutic guidelines in 2016. Vol. 11. 2015.
  7. Gandini S, Sera F, Cattaruzza MS, et al. Meta-analysis of risk factors for cutaneous melanoma: I. Common and atypical naevi. Eur J Cancer. 2005; 41(1): 28–44.
  8. Gandini S, Sera F, Cattaruzza MS, et al. Meta-analysis of risk factors for cutaneous melanoma: II. Sun exposure. Eur J Cancer. 2005; 41(1): 45–60.
  9. Gandini S, Sera F, Cattaruzza MS, et al. Meta-analysis of risk factors for cutaneous melanoma: III. Family history, actinic damage and phenotypic factors. Eur J Cancer. 2005; 41(14): 2040–2059.
  10. Brown KF, Rumgay H, Dunlop C, et al. The fraction of cancer attributable to modifiable risk factors in England, Wales, Scotland, Northern Ireland, and the United Kingdom in 2015. Br J Cancer. 2018; 118(8): 1130–1141.
  11. Mayer JE, Swetter SM, Fu T, et al. Screening, early detection, education, and trends for melanoma: current status (2007-2013) and future directions: Part I. Epidemiology, high-risk groups, clinical strategies, and diagnostic technology. J Am Acad Dermatol. 2014; 71(4): 599.e1–599.e12; quiz 610, 599.e12.
  12. Gulia A, Brunasso AG, Massone C. Dermoscopy: distinguishing malignant tumors from benign. Expert Review of Dermatology. 2014; 7(5): 439–458.
  13. Vestergaard ME, Macaskill P, Holt PE, et al. Dermoscopy compared with naked eye examination for the diagnosis of primary melanoma: a meta-analysis of studies performed in a clinical setting. Br J Dermatol. 2008; 159(3): 669–676.
  14. Bafounta ML, Beauchet A, Aegerter P, et al. Is dermoscopy (epiluminescence microscopy) useful for the diagnosis of melanoma? Results of a meta-analysis using techniques adapted to the evaluation of diagnostic tests. Arch Dermatol. 2001; 137(10): 1343–1350.
  15. Kittler H, Pehamberger H, Wolff K, et al. Diagnostic accuracy of dermoscopy. Lancet Oncol. 2002; 3(3): 159–165.
  16. Thomas L, Puig S. Dermoscopy, Digital Dermoscopy and Other Diagnostic Tools in the Early Detection of Melanoma and Follow-up of High-risk Skin Cancer Patients. Acta Derm Venereol. 2017; Suppl 218: 14–21.
  17. Marghoob A, Swindle L, Moricz C, et al. Instruments and new technologies for the in vivo diagnosis of melanoma. J Am Acad Dermatol. 2003; 49(5): 777–797.
  18. Kardynal A, Olszewska M. Modern non-invasive diagnostic techniques in the detection of early cutaneous melanoma. J Dermatol Case Rep. 2014; 8(1): 1–8.
  19. Marghoob AA, Usatine RP, Jaimes N. Dermoscopy for the family physician. Am Fam Physician. 2013; 88(7): 441–450.
  20. Liebman TN, Goulart JM, Soriano R, et al. Effect of dermoscopy education on the ability of medical students to detect skin cancer. Arch Dermatol. 2012; 148(9): 1016–1022.
  21. Robinson JK, Jain N, Marghoob AA, et al. A Randomized Trial on the Efficacy of Mastery Learning for Primary Care Provider Melanoma Opportunistic Screening Skills and Practice. J Gen Intern Med. 2018; 33(6): 855–862.
  22. Marchetti MA, Fonseca M, Dusza SW, et al. Dermatoscopic imaging of skin lesions by high school students: a cross-sectional pilot study. Dermatol Pract Concept. 2015; 5(1): 11–28.
  23. Geller AC, Venna S, Prout M, et al. Should the skin cancer examination be taught in medical school? Arch Dermatol. 2002; 138(9): 1201–1203.
  24. Dolan NC. Skin cancer control in the primary care setting: are we making any progress? J Gen Intern Med. 2001; 16(5): 342–343.
  25. Terushkin V, Warycha M, Levy M, et al. Analysis of the benign to malignant ratio of lesions biopsied by a general dermatologist before and after the adoption of dermoscopy. Arch Dermatol. 2010; 146(3): 343–344.
  26. Chen LL, Liebman TN, Soriano RP, et al. One-year follow-up of dermoscopy education on the ability of medical students to detect skin cancer. Dermatology. 2013; 226(3): 267–273.
  27. Garg A, Wang J, Reddy SB, et al. Integrated Skin Exam Consortium. Curricular factors associated with medical students' practice of the skin cancer examination: an educational enhancement initiative by the integrated skin exam consortium. JAMA Dermatol. 2014; 150(8): 850–855.
  28. Koelink CJL, Vermeulen KM, Kollen BJ, et al. Diagnostic accuracy and cost-effectiveness of dermoscopy in primary care: a cluster randomized clinical trial. J Eur Acad Dermatol Venereol. 2014; 28(11): 1442–1449.
  29. Westerhoff K, McCarthy WH, Menzies SW. Increase in the sensitivity for melanoma diagnosis by primary care physicians using skin surface microscopy. Br J Dermatol. 2000; 143(5): 1016–1020.