key: cord-0932497-4qic8bqx
authors: Caini, S.; Brusasco, M.; Niero, G.; De Giorgi, V.; Lombardo, M.; Massone, C.; Medri, M.; Palmieri, G.; Pizzichetta, M.A.; Quaglino, P.; Satta, R.; Feliciani, C.; Gandini, S.; Stanganelli, I.
title: Healthcare and safety of patients with melanoma during the COVID‐19 Pandemic in Italy
date: 2022-03-19
journal: J Eur Acad Dermatol Venereol
DOI: 10.1111/jdv.18056
sha: 0700eebf68c04f5d3b146509882d9b8292cf9b86
doc_id: 932497
cord_uid: 4qic8bqx

nan

The COVID-19 pandemic prompted drastic containment measures and a rearrangement of healthcare services. Several papers highlighted the reduction of melanoma diagnoses and related activities [1] [2] [3] [4] [5] ; however, limited data are available on healthcare quality and patient safety. 6 In Italy, the Italian Melanoma Intergroup (IMI) documented the decrease in first visits, diagnoses and surgeries related to melanoma during February-April 2020. 1 As a follow-up study, the IMI and the Italian Association of Melanoma Patients (AIMaMe) undertook a nationwide survey to evaluate the impact of the pandemic on healthcare quality and patient safety in melanoma management. AIMaMe members were invited to fill in an online questionnaire, and participants were divided into two groups based on when they received the indication for excision: pre-pandemic (Group 1, n = 334) and pandemic (Group 2, n = 252; Table 1) .

Regarding patient management, we found no differences between the groups. The main reasons for the dermatology visit were a suspicious lesion (42-44%) and a routine clinical evaluation of nevi (42-45%). There were also no differences in who to concern about COVID-19. Furthermore, in Raza et al., 8 lack of check-ups or long waiting times were more frequent during lockdown than before (72% vs. 28%). We also observed a lower rate of patients reporting delayed follow-up visits; but unexpectedly, among patients in group 2 (15% vs. 22.5% in group 1, 10% vs. 16.8% of which by decision of the health facilities).

Concerning perceived safety, the patients in the two groups did not differ in their fear of undergoing a procedure during the pandemic, and the percentage of patients who felt safe was even higher in group 2 (94.0% vs. 84.0%). This was consistent with Kurzhals et al., 6 who observed that the pandemic did not substantially affect the overall quality of life of skin cancer patients. The percentage of patients who considered melanoma management to be good/excellent during the pandemic was also higher in Group 2 (91.2% vs. 84.4%). The significantly higher rates of satisfaction and perceived safety in group 2 could be due to the fact that some of these patients received the diagnosis after the end of the lockdown, when the healthcare facilities had already re-organized their activities.

Finally, most group 1 patients (80.8%) stated that melanoma management was unchanged during the pandemic, while a smaller percentage reported a worsening (13.2%) or an improvement (6.0%).

A limitation of this study was that questionnaires were filled in only online. Patients less digitally competent, especially the elderly, may thus be under-represented. Survey participants may also be more health-conscious than non-participants, thereby possibly creating a selection bias. Finally, teledermatology was not investigated in our survey due to ongoing clinical validation and medico-legal restrictions.. 9, 10 In conclusion, healthcare quality and patient safety appear to have been generally guaranteed in melanoma management during the COVID-19 pandemic in Italy. Given the ongoing situation, additional multi-centre studies are required to determine the long-term impact of the pandemic on melanoma patients.

Italian Association of Melanoma patients (AIMaMe), a nonprofit patient association, for their great contribution and 

The effect of COVID-19 emergency in the management of melanoma in Italy

Impact of the COVID-19 pandemic on skin cancer diagnosis: a population-based study

COVID-19-related consequences on melanoma diagnoses from a local Italian registry in Genoa, Italy

COVID-19-induced reduction in primary melanoma diagnoses: experience from a dermatopathology referral center

Impact of the COVID-19 pandemic on melanoma diagnosis

The impact of the Covid-19 pandemic on quality of life in skin cancer patients

Effects of the COVID-19 pandemic on care of melanoma patients in Berlin, Germany: the Mela-COVID survey

Exploring the implications of the first COVID-19 lockdown on patients with melanoma: a national survey

Mobile teledermatology for melanoma detection: assessment of the validity in the framework of a population-based skin cancer awareness campaign in northern Italy

Digital dermoscopy monitoring: is it time to define a quality standard