Avoid unnecessary dermatology procedures

A US campaign, Choosing Wisely, provides recommendations on tests and treatments that are not always necessary, with the aim of helping patients to avoid unnecessary care

In August 2015 the American Academy of Dermatology produced its second Choosing Wisely list of recommendations regarding unnecessary dermatological tests and treatments.
A workgroup of dermatologists identified areas with the greatest potential for overuse or misuse, a need for quality improvement and the availability of strong evidence-based research to support the recommendation.
Its latest recommendations are:
  • Don’t use systemic (oral or injected) corticosteroids as a long-term treatment for dermatitis. The potential complications of long-term treatment with corticosteroids outweigh the potential benefits
  • Don’t use skin prick tests or blood tests such as RAST for the routine evaluation of eczema. Suspected allergies are better assessed using patch testing with ingredients of products that come into contact with the patient’s skin
  • Don’t routinely use microbiological testing in the evaluation and management of acne. Microbiological testing is generally unnecessary because it does not affect the management of typical acne patients
  • Don’t routinely use antibiotics to treat bilateral swelling and redness of the lower leg unless there is clear evidence of infection. Bilateral lower leg cellulitis is very rare
  • Don’t routinely prescribe antibiotics for inflamed epidermal cysts. It is important to confirm infection before treating these cysts with antibiotics
Choosing Wisely

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