Visual database of skin conditions aids in diagnosis, dermatological care

From acne to life-threatening skin cancer, skin diseases are a diverse group of conditions that can affect anyone. These diseases are among the most common health problems worldwide, with a significant impact on both high- and low-income countries.  

According to the Global Burden of Disease Study (2010), skin diseases can significantly impair quality of life, limit economic opportunities, and even lead to social stigma. In the United States alone, approximately 85 million people—or one in four—sought medical attention for at least one skin condition in 2013, resulting in direct healthcare costs of $75 billion.

Despite their prevalence and impact, dermatology education is often limited in medical school curricula. The majority of U.S. medical schools do not offer a dedicated course or mandatory rotation in this specialty. This lack of training is particularly concerning as patients frequently seek initial dermatological care from their primary care physicians. A study by Moreno et al found that general practitioners agreed with dermatologists on only 57% of diagnoses. This statistic is very concerning when you realize that many systemic diseases manifest first as a dermatological complaint. Patients with conditions like lupus, sarcoidosis, diabetes, and certain cancers usually seek initial care at their primary care physician. These misdiagnoses are compounded by a lack of expertise, even among dermatologists, in diagnosing skin conditions in people of color. Medical textbooks have been slow to include and represent conditions that affect pigmented skin, leading to potential misdiagnosis, delayed care, and compromised patient safety.

To address the lack of dermatological education in undergraduate medical training and increase exposure to skin conditions in people of color, the Penn Libraries has been actively acquiring new resources. A recent addition is VisualDx, a comprehensive clinical decision support system designed to enhance diagnostic accuracy, aid therapeutic decisions, and improve patient safety. VisualDx boasts an extensive database of more than 40,000 high-quality medical images, including the largest atlas of images featuring people of color. This versatile tool can significantly enhance a medical student’s education by facilitating case-based learning, helping explore differential diagnoses, and outlining treatment options.  Students can also use it for self-assessment when studying for the boards. Through VisualDx, medical students can gain a deeper understanding of dermatological diseases, improve their diagnostic skills, and ultimately provide better care to their patients.

VisualDX has quickly become a popular tool within the Penn community. One clinician at the Hospital of the University of Pennsylvania recently observed:

VisualDx has quickly moved from a "nice-to-have" to a "need-to-have" for clinical accuracy, medical school education, and patient teaching. I personally have a case where it helped me diagnose a rare "zebra" disease in the Emergency Department at HUP. When the Dermatology consult team saw the patient, they agreed with my assessment and stated they had never personally seen this rash and were impressed that an Emergency Department attending was able to recognize this extremely rare rash.

Another described a wide variety of use cases:  

I use VisualDx very often, it has great summary info for patients that I can print out for them, it also has dosing guidelines when common treatments fail, and you need to think "out of the box." I also use VisualDx to show patients images of conditions, which helps with education.

To supplement this valuable resource, Holman Biotech Commons continues to expand its collection of dermatological atlases for skin of color and monographs that support primary care physicians and their need for dermatological diagnostic support in their practice.

Here are some recent purchases:

Goodheart's Same-Site Differential Diagnosis: Dermatology for the Primary Health Care Provider  

Dermatology for the Primary Care Provider

Textbook of Primary Care Dermatology

Ethnic Skin and Hair and Other Cultural Considerations

Pediatric Dermatology in Skin of Color: A Practical Guide

Atlas of Black Skin

Skin of Color : A Practical Guide to Dermatologic Diagnosis and Treatment