Overcalling a teledermatology selfie: a new twist in a growing field

Abstract

Teledermatology via patient-generated digital images or "selfies" has been increasing since the advent of portable devices capable of high resolution image capture. During these early days, doctors and patients are learning about uses and limitations. We describe a case in which a patient's selfie led three attending physicians to suspect an iatrogenic hematoma requiring urgent assessment. There was no hematoma at follow up, simply dark and smooth adherent crust, which was gently removed to reveal a well-healing wound. This case introduces a previously undescribed teledermatology-related issue, that of "overcalling" a selfie. An image supplied by a patient misleadingly appeared to show a serious complication requiring urgent treatment.

Visual Diagnosis of Dermatological Disorders: Human and Machine Performance

“…III-C, the reported differences in human diagnosis performance during teledermatology suggests that diagnosing via static images may be significantly more challenging than diagnosis during face-to-face consultations. A further example is given by, Hogan et al [106] who documented a patient supplied image that appeared to contain serious complications, but on a face-to-face inspection revealed a crust covering a well-healing wound. Thus, claims that machines have reached human-level diagnostic ability should be considered in the context of static images.…”

Artificial Intelligence-Based Image Classification for Diagnosis of Skin Cancer: Challenges and Opportunities

“…Deep learning algorithms are found to be highly sensitive to which camera devices are used to capture the data, and their performance degrades if a different type of camera device is used for testing. Patient-provided self-captured skin images are frequently of low-quality and are not suitable for digital dermatology [50,51].…”