Teledermoscopy in the Diagnosis of Melanocytic and Non-Melanocytic Skin Lesions: NurugoTM Derma Smartphone Microscope as a Possible New Tool in Daily Clinical Practice

Abstract

Background: Due to the COVID-19 pandemic, teledermoscopy has been increasingly used in the remote diagnosis of skin cancers. In a study conducted in 2020, we demonstrated a potential role of an inexpensive device (NurugoTM Derma) as a first triage to select the skin lesions that require a face-to-face consultation with dermatologists. Herein, we report the results of a novel study that aimed to better investigate the performance of NurugoTM. Objectives: (i) verify whether the NurugoTM can be a communication tool between the general practitioner (GP) and dermatologist in the first assessment of skin lesions, (ii) analyze the degree of diagnostic–therapeutic agreement between dermatologists, (iii) estimate the number of potentially serious diagnostic errors. Methods: One hundred and forty-four images of skin lesions were collected at the Dermatology Outpatient Clinic in Novara using a conventional dermatoscope (instrument F), the NurugoTM (instrument N), and the latter with the interposition of a laboratory slide (instrument V). The images were evaluated in-blind by four dermatologists, and each was asked to make a diagnosis and to specify a possible treatment. Results: Our data show that F gave higher agreement values for all dermatologists, concerning the real clinical diagnosis. Nevertheless, a medium/moderate agreement value was obtained also for N and V instruments and that can be considered encouraging and indicate that all examined tools can potentially be used for the first screening of skin lesions. The total amount of misclassified lesions was limited (especially with the V tool), with up to nine malignant lesions wrongly classified as benign. Conclusions: NurugoTM, with adequate training, can be used to build a specific support network between GP and dermatologist or between dermatologists. Furthermore, its use could be extended to the diagnosis and follow-up of other skin diseases, especially for frail patients in emergencies, such as the current pandemic context.

Advancing Dermatological Care: A Comprehensive Narrative Review of Tele-Dermatology and mHealth for Bridging Gaps and Expanding Opportunities beyond the COVID-19 Pandemic

“…Nine reviews [22][23][24][25][28][29][30]36,38] and one systematic review [32]; • Twenty-five papers [21,26,27,31,[33][34][35][40][41][42][43][44][45]48,[50][51][52][53][54][55][56][57][58][59][60].…”

“…The search provided 40 components [ 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 ] in the three years since the COVID-19 pandemic outbreak (at the date of this study).…”

“…In detail, the components were: Two randomized controlled (clinical) trials (RCTs) [ 37 , 49 ]; Three observational studies (OS)s [ 39 , 46 , 47 ]; Nine reviews [ 22 , 23 , 24 , 25 , 28 , 29 , 30 , 36 , 38 ] and one systematic review [ 32 ]; Twenty-five papers [ 21 , 26 , 27 , 31 , 33 , 34 , 35 , 40 , 41 , 42 , 43 , 44 , 45 , 48 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 ]. …”

Impact of artificial intelligence‐based color constancy on dermoscopical assessment of skin lesions: A comparative study

“…Teledermatology, the provision of dermatology services at a distance, particularly benefits from the acquisition of digital dermoscopic images and can increase patient access to expert dermatologic care. In this context, numerous studies in literature have also recently focused on the use of a smartphone camera for skin lesion image acquisition, which could provide a potential tool for general practitioners who can filter out the clearly benign skin lesions and consult expert dermatologists only in dubious cases 2–5 . The acquisition of digital images of skin lesions further allows for the application of computer‐assisted methods, which have shown to obtain more accurate diagnostic results 6–9 .…”

“…In this context, numerous studies in literature have also recently focused on the use of a smartphone camera for skin lesion image acquisition, which could provide a potential tool for general practitioners who can filter out the clearly benign skin lesions and consult expert dermatologists only in dubious cases. [2][3][4][5] The acquisition of digital images of skin lesions further allows for the application of computer-assisted methods, which have shown to obtain more accurate diagnostic results. [6][7][8][9] However, the quality and appearance of digital skin lesion images depend on numerous factors.…”