Table 1.
Survey questions on nail examinations and management of longitudinal melanonychia, with responses stratified by level of clinical experience
| Survey questions and responses | Level of clinical experience* | P value† | ||
|---|---|---|---|---|
|
| ||||
| Resident (n = 142) | Junior attending physician (n = 58) | Senior attending physician (n = 199) | ||
| Do you ask your patients to remove all their nail polish during visits? | ||||
| Always | 2 (1.4) | 3 (5.2) | 27 (13.6) | <.0001 |
| Sometimes | 17 (12.0) | 18 (31.0) | 59 (29.7) | |
| Only when they complain of a nail problem | 117 (82.4) | 36 (62.1) | 105 (52.8) | |
| Never | 6 (4.2) | 1 (1.7) | 8 (4.0) | |
| How often do you examine the nails? | ||||
| Every visit | 13 (9.5) | 11 (19.0) | 47 (23.6) | <.0001 |
| Only during total body skin examinations | 55 (40.2) | 42 (72.4) | 132 (66.3) | |
| Only when the patient brings it to my attention | 69 (50.3) | 5 (8.6) | 20 (10.1) | |
| How often do you see melanonychia in your practice? | ||||
| At least once a week | 39 (27.5) | 18 (31.0) | 35 (17.6) | <.0001 |
| Approximately once a month | 81 (57.0) | 30 (51.7) | 65 (32.7) | |
| Approximately once every 3 months | 17 (12.0) | 4 (6.9) | 53 (26.6) | |
| Approximately once every 6 months | 5 (3.5) | 6 (10.3) | 46 (23.1) | |
| How confident are you with diagnosing and managing patients with melanonychia? | ||||
| Very confident | 5 (3.5) | 12 (20.7) | 54 (27.1) | <.0001 |
| Fairly confident | 49 (34.5) | 39 (67.2) | 128 (64.3) | |
| Not confident | 88 (62.0) | 7 (12.1) | 17 (8.6) | |
| When your patients present with melanonychia: | ||||
| You bring up the band to them | 99 (69.7) | 41 (70.6) | 135 (67.8) | .0002 |
| They bring up the band to you | 26 (18.3) | 15 (25.9) | 61 (30.7) | |
| Do not discuss it | 17 (12.0) | 2 (3.5) | 3 (1.5) | |
| What is your next step in management when a patient presents with a band concerning for SM? | ||||
| Continue your examination of the nails and skin | 43 (32.3) | 7 (12.7) | 40 (21.6) | .0326 |
| Schedule the patient for a biopsy specimen of the nail(s) | 43 (32.3) | 29 (52.7) | 83 (44.9) | |
| Take pictures of the nail and schedule a follow-up | 20 (15.1) | 9 (16.4) | 34 (18.4) | |
| Refer the patient to a dermatologic nail specialist | 27 (20.3) | 10 (18.2) | 28 (15.1) | |
| Are you aware of the ABC mnemonic described by Levit et al? | ||||
| Yes | 17 (12.0) | 17 (29.3) | 63 (32.0) | <.0001 |
| No | 125 (88.0) | 41 (70.7) | 134 (68.0) | |
| Correct multiple choice representation for mnemonic | ||||
| Correct | 12 (70.6) | 12 (75.0) | 43 (70.5) | 1 |
| Incorrect | 5 (29.4) | 4 (25.0) | 18 (29.5) | |
*
Unless otherwise noted, data are reported as number (percentage) of respondents.
†
P values obtained from χ2 tests for specified proportions with significance set to P < .05.