Are you Choosing Wisely®? Five New Recommendations Added
As part of a larger initiative of the American Board of Internal Medicine (ABIM) Foundation, The American Academy of Dermatology (AAD) formed a workgroup to develop an evidence-based list to guide physicians and patients in making informed health care decisions. Dermatologists who are current members of different Academy councils and committees identified areas to be included on this list based on the greatest potential for overuse/misuse, quality improvement and availability of strong evidence-based research. The recommended list was reviewed and approved by the AAD Council on Science and Research and the AAD Board of Directors. The recommendations were released as part of the broader Choosing Wisely® campaign aimed at helping patients avoid care that may be unnecessary for them. Five new recommendations were added this summer to create a list of ten tips for both doctors and patients.
The ten recommendations are:
1. Don’t use systemic (oral or injected) corticosteroids as a long-term treatment for dermatitis.
2. Don’t use skin prick tests or blood tests such as the radioallergosorbent test (RAST) for the routine evaluation of eczema.
3. Don’t routinely use microbiologic testing in the evaluation and management of acne.
4. Don’t routinely use antibiotics to treat bilateral swelling and redness of the lower leg unless there is clear evidence of infection.
5. Don’t routinely prescribe antibiotics for inflamed epidermal cysts.
6. Don’t prescribe oral antifungal therapy for suspected nail fungus without confirmation of a fungal infection.
7. Don’t perform sentinel lymph node biopsy or other diagnostic tests for the evaluation of early, thin melanoma because they do not improve survival.
8. Don’t treat uncomplicated, nonmelanoma skin cancer less than 1 centimeter in size on the trunk and extremities with Mohs micrographic surgery.
9. Don’t use oral antibiotics for treatment of atopic dermatitis unless there is clinical evidence of infection.
10. Don’t routinely use topical antibiotics on a surgical wound.
According to board-certified dermatologist Mark Lebwohl, MD, FAAD, president of the Academy. “By identifying procedures that may not be necessary, the Academy’s new Choosing Wisely® list can help patients with skin, hair and nail conditions start a conversation with their dermatologist about what tests and treatments are right for them.”
Byline: Martha L. Sikes, MS, RPh, PA-C and Wendy Meltzer, MPH
Adapted from the original flier and press release.
[image by Squidish]