Teledermatology—high technology or not?

Abstract

As an alternative to attending a conventional dermatology clinic, patients had a high-resolution conventional photographic image taken by a professional medical photographer. The photographic images were viewed by a dermatologist together with referral details from the general practitioner and any other relevant information from the patient's notes. From the images, a dermatological diagnosis was derived and a management plan for each patient instituted. After treatment, histological assessment of the tumours allowed diagnostic accuracy to be determined. The preliminary diagnostic accuracy (71%) was greater than that of the referring general practitioners (49%). However, when the diagnostic ability of the method to detect the nature of malignant lesions was examined, telemedicine was able to detect malignancies in 94% of cases compared with only 70% detected by general practitioners. The results of the present study indicate that teledermatology is achievable using a low-technology, low-cost approach.

Examination of skin lesions for cancer: Which clinical decision aids and tools are available in general practice?

“…The advantages of teledermatology are a reduction in the number of referrals up to 51%, [78,79,88,89] and the educational value for GPs [78,90]. Furthermore, the recommendations given via teledermatology are simple to implement [91] and both patients and doctors are satisfied with teledermatology [78,90,92,93]. The disadvantages of teledermatology are an extension of the overall time for consultation [91,94].…”

“…In the Netherlands, pigmented lesions are considered less suitable for examination by teledermatology [98]. And, although several studies have shown the utility of teledermatology for pigmented lesions [79,80,86,92,93,99,100], in one study almost 20% of the melanomas would have been mismanaged by teledermatology [101]. Furthermore, the effectiveness and efficiency of teledermatology for suspicious skin lesions have been questioned, as a high proportion of the patients still need a face-to-face consultation [102,103].…”

Decision Support Software to Help Primary Care Physicians Triage Skin Cancer

“…The efficacy of teledermatology-dermatologists consulting on cases presented via videoconferencing or electronically transmitted digitized images-is now being explored as a means to make consultation by dermatolo- gists more accessible and cost-effective. 12,13 The use of teledermatology may complement our decision support software, which is intended to help primary care physicians make better decisions about when to consult with dermatologists. The decision support software developed in this study is intended to ultimately serve as a decision-making aid and a teaching tool.…”

Dermatologie in der Telemedizin

“…Die Akzeptanz der telemedizinischen Konsultationen ist bei den Patienten und Dermatologen im Allgemeinen sehr hoch [2,16,25]. Das Beurteilen einer solitären Läsion wird oftmals als einfacher angesehen als das disseminierter Hautveränderungen.…”