From the Journals

Patients lack confidence in their skin self-exam abilities



Elderly patients with a history of localized melanoma recognized the importance of skin self-examination (SSE), but expressed low confidence in their abilities to do it correctly, based on results of a small study. While many were willing to use teledermoscopy to assist them in self-exams, patients still preferred to rely on regularly scheduled exams by physicians.

“Low confidence in SSE is a key barrier to patient-led surveillance and to the use of digital technologies for SSE,” wrote Mbathio Dieng, PhD, of the University of Sydney and her coauthors in a study published in JAMA Dermatology.

The Australian researchers conducted semistructured interviews with 37 patients from Sydney. Patients’ median age was 67 years; 26 of 37 (70%) were men.

Barriers to SSE included a perceived lack of competence in self-exams; the patients said they doubted they would catch anything that needed to be caught.

As for digitally supported SSE, many patients expressed a willingness to consider tools that would assist in the self-assessment process. Several said they valued the additional reassurance between clinical visits and the ability to create their own action plan.

The authors acknowledged that they only recruited from a single tertiary center so the results are limited. However, in terms of steps forward, they noted that their study was one of the first “to assess the perceptions of patients with melanoma of the use of new digital technologies in surveillance for recurrent or new primary melanomas.”

The study was supported by a grant from the Australian National Health and Medical Research Council (NHMRC). One author reported receiving salary support from an Australian NHMRC fellowship; another received fellowships from the NHMRC and Cancer Institute New South Wales. Another author received scholarships and awards from the University of Sydney and the Sydney Catalyst Translational Cancer Research Centre.

SOURCE: Dieng M et al. JAMA Dermatol. 2019 May 15. doi: 10.1001/jamadermatol.2019.0434.

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