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• W3197497651 abstract "To the Editor: While representing 0.7% to 3.5% of all melanoma diagnoses, nail melanoma is associated with a high mortality rate due to its late stage at presentation and aggressive nature.1Levit E.K. Kagen M.H. Scher R.K. Grossman M. Altman E. The ABC rule for clinical detection of subungual melanoma.J Am Acad Dermatol. 2000; 42: 269-274https://doi.org/10.1016/S0190-9622(00)90137-3Abstract Full Text Full Text PDF PubMed Scopus (224) Google Scholar Nail salons are potentially an ideal setting for community-level intervention given their “primary screening” access to their client's nails. A study conducted with English-speaking nail technicians revealed that only 8% knew of nail melanoma signs, highlighting an important educational opportunity.2Kream E. Adelzadeh L. Refeld R. et al.Subungual melanoma: the attitudes, knowledge, and referral patterns of nail technicians.J Am Acad Dermatol. 2018; 79: AB272https://doi.org/10.1016/j.jaad.2018.05.1079Abstract Full Text Full Text PDF Google ScholarWe conducted a pilot study with 54 nail technicians in North Carolina investigating the utility of an educational video on nail melanoma screening using a model previously applied to alopecia education for hairstylists.3Veerabagu S.A. Lauth M.J. Obayomi A. Correa M. Murina A.T. Hair stylists as screeners for scarring hair loss within the African American community: a cross-sectional study.Br J Dermatol. 2021; 184: 769-770https://doi.org/10.1111/bjd.19688Crossref PubMed Scopus (1) Google Scholar All materials were available in English and Vietnamese. Participants watched a 2-minute educational video outlining the warning signs of nail melanoma, emphasizing Hutchinson sign, longitudinal melanonychia on an isolated digit, and nail dystrophy (Supplemental Table 1 and Supplemental Material available via Mendeley at 10.17632/jm62fx668j.1). Before and after the video, the participants used a modified Likert scale to report their likelihood of referring clients to a dermatologist for nail changes in a series of photographs. Each photograph showed either biopsy-proven nail melanoma or a benign nail condition (pseudoleukonychia, splinter hemorrhage, or habit tic deformity) (Supplemental Table 2 available via Mendeley at 10.17632/jm62fx668j.1).Of the 54 respondents, 39 (72%) completed the full assessment, with 78% completing the survey in English and 22% in Vietnamese (Supplemental Table 3 available via Mendeley at 10.17632/jm62fx668j.1). Among 45 (83%) participants who reported learning about nail disease in training, there was a negative association between years of experience and recognition of nail melanoma on the prevideo quiz (P < .001) (Supplemental Fig 1 available via Mendeley at 10.17632/jm62fx668j.1).The ability to identify the signs of nail melanoma improved after the educational video (P < .001), with nearly twice as many participants responding that they would “definitely refer” a client when shown a photograph of nail melanoma. Particularly, the recognition of longitudinal melanonychia and nail dystrophy improved (P < .001 and P < .01, respectively) (Fig 1). Although the overall likelihood of referral for the 3 benign “controls” was not significantly increased, referral likelihood for splinter hemorrhages significantly increased (P < .05). This may indicate an area worth improving in future educational interventions.After the video, more respondents rated their confidence about referring for these signs as either “high” or “very high” (49% prevideo vs 80% postvideo, P < .001). The top reasons for referral hesitancy included fear of being wrong, losing or upsetting a client, and not knowing where to refer clients. Referral patterns, costs, and benefits thereof were not formally assessed but may be worth consideration for future investigation.Equipping nail salon technicians to serve as “community screeners” has the potential to save the lives of those with nail melanoma. The negative correlation between years of experience and knowledge of nail melanoma underscores the importance of this material in cosmetic school curricula and the need for continuing education for knowledge retention. Given these findings, it may be advantageous for national organizations, such as the American Academy of Dermatology, to build curricula for nail technicians. To the Editor: While representing 0.7% to 3.5% of all melanoma diagnoses, nail melanoma is associated with a high mortality rate due to its late stage at presentation and aggressive nature.1Levit E.K. Kagen M.H. Scher R.K. Grossman M. Altman E. The ABC rule for clinical detection of subungual melanoma.J Am Acad Dermatol. 2000; 42: 269-274https://doi.org/10.1016/S0190-9622(00)90137-3Abstract Full Text Full Text PDF PubMed Scopus (224) Google Scholar Nail salons are potentially an ideal setting for community-level intervention given their “primary screening” access to their client's nails. A study conducted with English-speaking nail technicians revealed that only 8% knew of nail melanoma signs, highlighting an important educational opportunity.2Kream E. Adelzadeh L. Refeld R. et al.Subungual melanoma: the attitudes, knowledge, and referral patterns of nail technicians.J Am Acad Dermatol. 2018; 79: AB272https://doi.org/10.1016/j.jaad.2018.05.1079Abstract Full Text Full Text PDF Google Scholar We conducted a pilot study with 54 nail technicians in North Carolina investigating the utility of an educational video on nail melanoma screening using a model previously applied to alopecia education for hairstylists.3Veerabagu S.A. Lauth M.J. Obayomi A. Correa M. Murina A.T. Hair stylists as screeners for scarring hair loss within the African American community: a cross-sectional study.Br J Dermatol. 2021; 184: 769-770https://doi.org/10.1111/bjd.19688Crossref PubMed Scopus (1) Google Scholar All materials were available in English and Vietnamese. Participants watched a 2-minute educational video outlining the warning signs of nail melanoma, emphasizing Hutchinson sign, longitudinal melanonychia on an isolated digit, and nail dystrophy (Supplemental Table 1 and Supplemental Material available via Mendeley at 10.17632/jm62fx668j.1). Before and after the video, the participants used a modified Likert scale to report their likelihood of referring clients to a dermatologist for nail changes in a series of photographs. Each photograph showed either biopsy-proven nail melanoma or a benign nail condition (pseudoleukonychia, splinter hemorrhage, or habit tic deformity) (Supplemental Table 2 available via Mendeley at 10.17632/jm62fx668j.1). Of the 54 respondents, 39 (72%) completed the full assessment, with 78% completing the survey in English and 22% in Vietnamese (Supplemental Table 3 available via Mendeley at 10.17632/jm62fx668j.1). Among 45 (83%) participants who reported learning about nail disease in training, there was a negative association between years of experience and recognition of nail melanoma on the prevideo quiz (P < .001) (Supplemental Fig 1 available via Mendeley at 10.17632/jm62fx668j.1). The ability to identify the signs of nail melanoma improved after the educational video (P < .001), with nearly twice as many participants responding that they would “definitely refer” a client when shown a photograph of nail melanoma. Particularly, the recognition of longitudinal melanonychia and nail dystrophy improved (P < .001 and P < .01, respectively) (Fig 1). Although the overall likelihood of referral for the 3 benign “controls” was not significantly increased, referral likelihood for splinter hemorrhages significantly increased (P < .05). This may indicate an area worth improving in future educational interventions. After the video, more respondents rated their confidence about referring for these signs as either “high” or “very high” (49% prevideo vs 80% postvideo, P < .001). The top reasons for referral hesitancy included fear of being wrong, losing or upsetting a client, and not knowing where to refer clients. Referral patterns, costs, and benefits thereof were not formally assessed but may be worth consideration for future investigation. Equipping nail salon technicians to serve as “community screeners” has the potential to save the lives of those with nail melanoma. The negative correlation between years of experience and knowledge of nail melanoma underscores the importance of this material in cosmetic school curricula and the need for continuing education for knowledge retention. Given these findings, it may be advantageous for national organizations, such as the American Academy of Dermatology, to build curricula for nail technicians. Dr. Lipner serves as a consultant to Ortho-Dermatologics, Hoth Therapeutics, and Verrica. Authors Gaghan and Bui and Drs Jellinek and Mervak have no conflicts of interest to disclose." @default.
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• W3197497651 title "Evaluation of a community education tool for detection of nail melanoma by nail salon technicians" @default.
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