High-Value Dermatology: Five Laboratory Tests to Reconsider

December 2017 in “ Journal of The American Academy of Dermatology ”

Oluwatobi A Ogbechie-Godec, Jason F. Wang, Hao Feng, Seth J. Orlow

spironolactone isotretinoin terbinafine thyroid function tests ANA screening CBC CMP biologic therapies Accutane Lamisil Complete Blood Count Comprehensive Metabolic Panel

TLDR The article suggests that five common skin-related lab tests may be unnecessary and could cause extra cost and anxiety without improving patient care.

The article from June 2018 highlights the importance of evidence-based practices in dermatology and questions the utility of five common laboratory tests in this field. These tests are: potassium monitoring for healthy young women using spironolactone for acne, frequent lab monitoring for patients on isotretinoin and terbinafine, thyroid function tests in asymptomatic individuals with new vitiligo diagnoses, ANA screening without strong suspicion of connective tissue disease, and routine CBC and CMP monitoring for patients on biologic therapies. The authors suggest that these tests may not significantly impact patient care and could lead to unnecessary anxiety, costs, and care coordination issues. They recommend adopting flexible, evidence-based guidelines and focusing clinical decisions on meaningful laboratory tests rather than routine practices.

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