Dermatology Weekly

Full-body skin examinations (FBSEs) are routine in dermatology practice but can create anxiety for some patients. Dr. Vincent DeLeo talks to Dr. Atieh Jibbe about reducing patient anxiety caused by FBSEs based on results from a patient questionnaire. They discuss factors that may contribute to patient anxiety and common body areas that patients prefer to exclude from FBSEs. They also provide tips for residents in training. “If you walk a patient through the exam as you’re doing it, it makes them feel a little bit more in control of the situation rather than just unexpectedly revealing certain parts of their body,” Dr. Jibbe explains.

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We also bring you the latest in dermatology news and research:

• Biologics may carry melanoma risk for patients with immune-mediated inflammatory disease
• Atopic dermatitis in adults, children linked to neuropsychiatric disorders
• Should healthcare workers wear masks at home?

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Key takeaways from this episode:

• Patients may have differences in comfort level during FBSEs, based on factors such as religious practices, the sex of the clinician, or concerns about undressing and/or wearing a gown.
• It is important to recognize and discuss potential concerns with patients before starting the exam. “Oftentimes, I think the lack of acknowledgment of [a patient’s] anxiety or the lack of acknowledgment of the fact that we are doing a sensitive exam can make people feel more uncomfortable,” Dr. Jibbe explained.
• Results from a pre-encounter patient questionnaire indicated there was a female predominance in exclusion of certain body parts examined and preference for being asked what areas they wanted examined. “Also we found that more females [reported] a [positive] change in their anxiety level after the postexamination survey,” Dr. Jibbe noted.
• When asked which areas to exclude from FBSEs, the genitals were most commonly excluded among both men and women. Other areas included the buttocks, breast/chest, legs, feet, and abdomen.
• It is important for clinicians to identify themselves as soon as they walk into the examination room to reduce patient anxiety. “Patients are more apt to be more comfortable if they know who you are, your name, what your role is in the health care profession, and what you’re doing for them,” Dr. Jibbe advises.
• Begin the exam by asking the patient to point out the areas or lesions he/she is worried about: “That immediately gives you a segue to go start an exam, and I feel that a patient would be more comfortable if they’re indicating on their body what they want you to start looking at, and then you can transition to the full-body skin exam from there,” Dr. Jibbe says.

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Hosts: Nick Andrews; Vincent A. DeLeo, MD (Keck School of Medicine of the University of Southern California, Los Angeles)

Guest: Atieh Jibbe, MD (University of Kansas Medical Center, Kansas City)

Disclosures: Dr. DeLeo is a consultant for Esteé Lauder. Dr. Jibbe reports no conflict of interest.

Show notes by: Alicia Sonners, Melissa Sears

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