Face-to-face diagnosis vs telediagnosis of pigmented skin tumors: a teledermoscopic study

Arch Dermatol. 1999 Dec;135(12):1467-71. doi: 10.1001/archderm.135.12.1467.

Abstract

Background: Teledermoscopy uses telecommunication technologies to transfer images of pigmented skin lesions, including clinical and anamnestic data, via e-mail to specialized centers for teleconsultation.

Design: Sixty-six pigmented skin lesions examined on a face-to-face basis in a skin lesion clinic in L'Aquila, Italy, were sent via e-mail on a standard-resolution color monitor for consultation at a university dermatology department in Graz, Austria.

Intervention: Digital photographs of the clinical and dermoscopic images of all pigmented tumors were taken with a stereomicroscope connected to a high-resolution video camera in Truevision advanced graphic array (Targa) format file and converted successively into a Joint Photographic Expert Group (PEG) format file. All lesions were excised surgically and diagnosed histopathologically.

Main outcome measure: Diagnostic concordance between face-to-face diagnosis and telediagnosis.

Results: The diagnostic concordance was 60 (91%) of 66 cases. The number of correct telediagnoses was lower, but the difference was not statistically significant (Wilcoxon test, P = .10). The accuracy of the telediagnoses was not related to the quality of the images, but highly depended on the level of diagnostic difficulty of a given pigmented skin tumor (Spearman correlation, P= .01).

Conclusion: Teleconsultation of clinical and dermoscopic images of skin tumors via e-mail provides a similar degree of diagnostic accuracy as face-to-face diagnosis.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Diagnosis, Differential
  • Endoscopes*
  • Female
  • Humans
  • Image Processing, Computer-Assisted / instrumentation*
  • Male
  • Melanoma / diagnosis*
  • Melanoma / pathology
  • Middle Aged
  • Nevus, Pigmented / diagnosis*
  • Nevus, Pigmented / pathology
  • Patient Care Team
  • Remote Consultation*
  • Sensitivity and Specificity
  • Skin / pathology
  • Skin Neoplasms / diagnosis*
  • Skin Neoplasms / pathology
  • Video Recording / instrumentation*