Recognition of actinic keratosis. A retrospective biopsy study of the clinical diagnostic accuracy by primary care physicians compared with dermatologists. Experience in Mexico

Abstract

Background. Actinic keratoses (AK) are dysplastic keratinocytic lesions confined to the epidermis. Currently, the standard screening method for detecting AK is performed by a health professional. Objectives. We seek to determine if were differences in diagnosis of AK by dermatologists (DL) and primary care physicians (PCP) in Mexico. Material and Methods. The clinical diagnoses of PCP and DL were correlated with histopathologic diagnoses. In total, 285 cases were analyzed. Results. DL diagnosed 90% (256/285) of the cases compared with 36% (102/285) of PCP (P= .001). Primary care physicians were the group with the lowest diagnostic accuracy rate. Conclusion: Primary care physician needs to acquire sufficient knowledge of basic dermatology as well as dermatopathology. The overall accuracy of the clinical diagnosis, mainly in hyperplastic AK, depends on the clinicopathologic correlation.

Keywords

• actinic keratosis
• clinicopathologic correlation
• dermatologist
• diagnostic accuracy
• primary care physician