Excision pathways for keratinocyte cancers diagnosed by teledermatology: a retrospective review.

IF 1.1 Q4 PRIMARY HEALTH CARE Journal of primary health care Pub Date : 2024-03-01 DOI:10.1071/HC23098
J P Tirado-Perez, A Oakley, R Gansel
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Abstract

Introduction The New Zealand population has one of the highest incidences of skin cancer in the world. Hospital waiting lists for surgical excision of keratinocytic skin cancers (basal cell carcinoma and squamous cell carcinoma) are lengthy, and increasingly, excisions are undertaken in primary care. Teledermatology, in response to general practitioners' electronic referrals (e-referrals), can improve clinical communication between general practitioners and dermatologists. Aim The aim of this study was to evaluate an excision pathway for keratinocytic cancers diagnosed by teledermatology. Methods A retrospective observational descriptive review of a 3-month cohort of primary care e-referrals was undertaken. Results Three hundred and fifty eight suspected keratinocytic cancers (KCs) were diagnosed by teledermatology; histology reports confirmed KC in 201 of 267 excisions (75%). The majority (77.2%) were excised by general practitioners an average of 25 days after the dermatologist's recommendation. The rest were excised by plastic surgeons in private (3.4%) or at a public hospital (19.5%) after an average of 40 or 134 days, respectively. Discussion E-referral pathways are now widely implemented. However, the ideal workflow for skin cancer management is unknown. We have demonstrated in New Zealand that surgery can be undertaken in primary care within a month of a teledermatology diagnosis and excision recommendation. Conclusion This study reports prompt excision of KCs by general practitioners after an e-referral and a teledermatology response.

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通过远程皮肤学诊断的角质细胞癌的切除途径:回顾性研究。
导言 新西兰是世界上皮肤癌发病率最高的国家之一。医院等待角化细胞皮肤癌(基底细胞癌和鳞状细胞癌)切除手术的时间很长,越来越多的切除手术在基层医疗机构进行。针对全科医生的电子转诊(电子转诊),远程皮肤病学可以改善全科医生和皮肤病医生之间的临床沟通。目的 本研究旨在评估通过远程皮肤科诊断的角化细胞癌的切除路径。方法 对为期 3 个月的初级医疗电子转诊进行回顾性观察描述。结果 远程皮肤科诊断出 358 例疑似角化细胞癌(KC);267 例切除术中有 201 例(75%)的组织学报告证实为角化细胞癌。大多数患者(77.2%)是在皮肤科医生建议后平均 25 天由普通医生进行切除的。其余患者分别在平均 40 天或 134 天后由私立整形外科医生(3.4%)或公立医院整形外科医生(19.5%)进行切除。讨论 目前,电子转诊途径已广泛应用。然而,皮肤癌治疗的理想工作流程仍是未知数。我们已在新西兰证明,在获得远程皮肤科诊断和切除建议后的一个月内,可在初级医疗机构进行手术。结论 本研究报告显示,全科医生在接到电子转诊和远程皮肤病学回复后可迅速对 KC 进行切除。
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来源期刊
Journal of primary health care
Journal of primary health care PRIMARY HEALTH CARE-
CiteScore
2.70
自引率
16.70%
发文量
79
审稿时长
28 weeks
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