From naked eye to dermoscopy: Closing a diagnostic gap in South African primary care

Abstract

Skin pathology is among the commonest reasons for South African primary care consultations, yet the dermatology workforce is small and unevenly distributed. Only 264 dermatologists serve a population of over 60 million, at 20.1 per million in the private sector and 1.2 per million in the public sector. Most patients with skin-related concerns usually present to general practitioners or family physicians first, who largely work with naked-eye examination alone. Dermoscopy is an evidence-based tool that significantly improves the accuracy of skin lesion assessment and is becoming routinely used in primary care in countries such as the United Kingdom and Australia.
Contribution: This article argues that dermoscopy should be reconsidered as a possible primary care skill in South Africa, keeping in mind that implementation is dependent on necessary equipment and training.