Use of and beliefs about total body photography and dermatoscopy among US dermatology training programs: An update

• Published in: Journal of the American Academy of Dermatology 2010-05, Vol.62 (5), p.794-803
• Main Authors: Terushkin, Vitaly, BS, Oliveria, Susan A., ScD, MPH, Marghoob, Ashfaq A., MD, Halpern, Allan C., MD
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Culture; Dermatology; Dermatology - education; dermatology residency programs; dermatoscopy; Dermoscopy - trends; Humans; Internship and Residency; Medical sciences; Melanoma - diagnosis; Nevus, Pigmented - diagnosis; Photography - education; Photography - trends; survey; Surveys and Questionnaires; total body photography; United States
• ISSN: 0190-9622; 1097-6787
• DOI: 10.1016/j.jaad.2009.09.008

Background Total body photography (TBP) and dermatoscopy are imaging techniques used to treat patients with pigmented lesions. Objective We sought to describe use, training, logistics, and beliefs about these tools among residency programs and to assess changes during a 10-year period. Methods Surveys were sent to all directors (n = 111) and chief residents (n = 109) of US dermatology training programs. Results A total of 83 (74.8%) attendings answered the questionnaire. In all, 59 (71.1%) reported using TBP, an 11.9% increase ( P  = .2484) over the past decade. Reasons for using TBP included: reduces patient anxiety (81.4%), helps detect early melanoma (78.0%), and leads to fewer biopsies (66.1%). Logistical (79.2%) and financial (45.8%) constraints were reasons for not using TBP. Seventy respondents (84.3%) reported using dermatoscopy, a 40.0% increase ( P  = .0001) over the 10-year period. Reasons for dermatoscopy use were consistent over time: helps find melanoma in curable stage (75.7%), reduces patient anxiety (61.4%), and leads to fewer biopsies (57.1%). The most common reason for not using dermatoscopy remained lack of training (38.5%). A total of 92 (84.4%) residents completed their survey, of which 41 (44.6%) and 81 (88.0%) reported using TBP and dermatoscopy, respectively. In all, 62 (67.4%) and 79 (85.9%) respondents would prefer additional training in TBP and dermatoscopy, respectively. Limitations Results may not be applicable to the general dermatology community. Conclusions Use of dermatoscopy among residency programs has increased significantly during the last decade. A more modest increase in the use of TBP was observed. Barriers to diffusion of these technologies into practice persist, including insufficient logistics and training.