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Halteh P, Scher R, Artis A, et al. Assessment of Patient Knowledge of Longitudinal Melanonychia: A Survey Study of Patients in Outpatient Clinics. Skin Appendage Disord. 2016;2(3):156-161doi: 10.1159/000452673.
Halteh, P., Scher, R., Artis, A., & Lipner, S. (2017). Assessment of Patient Knowledge of Longitudinal Melanonychia: A Survey Study of Patients in Outpatient Clinics. Skin appendage disorders, 2(3), 156-161. https://doi.org/10.1159/000452673
Halteh, Pierre, et al. "Assessment of Patient Knowledge of Longitudinal Melanonychia: A Survey Study of Patients in Outpatient Clinics." Skin appendage disorders vol. 2,3 (2017): 156-161. doi: https://doi.org/10.1159/000452673
Halteh P, Scher R, Artis A, Lipner S. Assessment of Patient Knowledge of Longitudinal Melanonychia: A Survey Study of Patients in Outpatient Clinics. Skin Appendage Disord. 2017 Jan;2(3):156-161. doi: 10.1159/000452673. Epub 2016 Nov 09. PMID: 28232925; PMCID: PMC5264350.
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Skin Appendage Disord. 2017 Jan;2(3):156-161. doi: 10.1159/000452673. Epub 2016 Nov 09.

Assessment of Patient Knowledge of Longitudinal Melanonychia: A Survey Study of Patients in Outpatient Clinics.

Skin appendage disorders

Pierre Halteh, Richard Scher, Amanda Artis, Shari Lipner

Affiliations

  1. Department of Dermatology, Weill Cornell Medical College, New York, NY, USA.
  2. Division of Biostatistics and Epidemiology, Weill Cornell Medical College, New York, NY, USA.

PMID: 28232925 PMCID: PMC5264350 DOI: 10.1159/000452673

Abstract

IMPORTANCE: Subungual melanoma (SM) is a rare subtype of cutaneous melanoma but carries a worse prognosis than similarly staged cutaneous melanomas. Assessing patient knowledge of melanonychia is integral to early diagnosis of SM.

OBJECTIVES: The aim of this paper is to determine patient knowledge of longitudinal melanonychia (LM) and warning signs for SM, frequency of nail self-examinations, and satisfaction of patients with their physician's nail examinations.

DESIGN SETTING AND PARTICIPANTS: We conducted a survey-based study of 363 random patients at Weill Cornell Medicine in New York, USA, performed at 3 different clinics: a general dermatology clinic (

MAIN OUTCOMES AND MEASURES: Knowledge of the ABCDEF mnemonic for SM was compared to the ABCD mnemonic for cutaneous melanoma. Analyses were performed for patient behavior regarding suspicious nail changes as well as satisfaction with nail counseling and examination.

RESULTS: Only 5% (18/363) of the patients in our study had heard of the ABCDEF mnemonic. In contrast, 9.9% (36/363) of the patients had heard of the ABCD mnemonic for cutaneous melanoma. In total, 37/363 (10.2%) patients reported having LM, 32.4% (12/37) of the patients noted changes in color or width of the band, and 10.8% (4/37) presented with pain or bleeding of the nail, with only 45.9% (17/37) seeking medical attention. Only 11.8% (43/363) of the patients stated that their physician asked them about nail changes, and 1.4% (5/363) of the patients stated that they were counseled about the ABCDEF mnemonic. In comparison, 13.8% (50/363) of the patients were advised on the ABCD mnemonic for the cutaneous melanoma mnemonic. While 70.2% (255/363) of the patients stated that they used sunscreen or wore sun-protective clothing, only 31.4% (114/363) assessed their nails for color changes, with 54.9% (128/233) of the patients categorizing themselves as "very unsatisfied" with the evaluation of their nails by their dermatologist.

CONCLUSIONS AND RELEVANCE: Our data shows that there is a lack of patient knowledge of LM and warning signs for SM. Further testing is needed to determine whether educating patients about LM, warning signs for SM, and nail self-examinations would improve patient outcomes.

Keywords: Melanoma; Melanonychia; Nail disorder

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