AAD issues top five Choosing Wisely recommendations

(HealthDay)—The top five dermatology-related issues that physicians and patients should question have been released by the American Academy of Dermatology (AAD) as part of the Choosing Wisely campaign, and have been published in the December issue of the Journal of the American Academy of Dermatology.

Brett M. Coldiron, M.D., from the Skin Cancer Center in Cincinnati, and Roseanne M. Fischoff, M.P.P., from the American Academy of Dermatology in Schaumberg, Ill., discuss the participation of the AAD in the Choosing Wisely campaign. They present a list of five overused or misused tests or procedures that provide little benefit and potential harm, at unnecessary cost, as indicated through evidence-based medicine.

The top five recommendations include: (1) not prescribing oral antifungal therapy for suspected nail fungus without confirmation of fungal infection; (2) in early, thin melanoma, sentinel lymph node biopsy, or other diagnostic tests should not be performed because they do not improve survival; (3) uncomplicated, non-melanoma skin cancer less than 1 cm in size on the trunk and extremities should not be treated with Mohs micrographic surgery; (4) unless there is clinical evidence of infection, oral antibiotics should not be used for treatment of atopic dermatitis; and (5) topical antibiotics should not be routinely used on a surgical wound.

"AAD participation in the Choosing Wisely campaign supports its commitment to providing the most appropriate, cost-effective, evidence-based treatment of skin, hair, and nail conditions and allows for a more meaningful dialogue between dermatologists and patients," the authors write.

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