gms | German Medical Science

Background: From 2008 to 2011 a guideline and web-based tool on skin lesions, targeted on preventive youth health care (PYHC) was developed in the Netherlands.

Context: Skin lesions are frequently seen in PYHC and parents and child caregivers ask many questions about spots and stains on the skin. Some of them may be the result of (underlying) diseases, syndromes or child abuse. Skin lesions can have severe impact such as itching or bullying. Therefore, prevention, detection, diagnosis, treatment, and/or referral, uniform advice and guidance are of great importance. In all these tasks PYHC could perform an important role, since 95% of all Dutch children are seen by PCHC. In the current project, the Dutch evidence based guideline development methodology was followed. Literature searches were done on specific subjects (for example dry skin, eczema) that were selected by determining key clinical questions. In addition, an expert group reached consensus on the criteria for referral of specific skin disorders (i.e, naevus, hemangioma), which could be associated with underlying diseases, such as malignancy.

Description of best practice: We anticipated on guideline adherence by developing a practical web-based tool, in which evidence and expert-based information of over 75 skin lesions including pictures and a decision tree for possible actions, were incorporated (http: //jgzhuid.plusportservices.com/). Furthermore, both the draft guideline and the tool were pilot tested in daily practice by PCHC professionals before final publication.

Lessons learned: The web-based tool will be presented as well as the results from the pilot implementation.