Teledermoscopy

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 Authored by: Katie Lee     ·  H. Peter Soyer

 Keywords:   teledermoscopy · mobile teledermoscopy
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Description This chapter covers the aspects of teledermoscopa and mobile teledermoscopyThis glossary term has not yet been described.
Author(s) Katie Lee · H. Peter Soyer
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Status released
Status update July 13, 2017
Status by Ralph P. Braun
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TeledermoscopyThis glossary term has not yet been described.

Teledermatology is the provision of dermatology services at a distance, using technology; it improves the efficiency of high-quality care by moving patient information instead of the patient themselves. Teledermatology is now an accepted part of many public health systems [1][2][3]; it has also proven useful for medical staff on commercial ships [4]and military personnel on deployment [5].

Due to the highly visual nature of dermoscopyDermoscopy is a non invasive diagnostic method., teledermoscopyThis glossary term has not yet been described. in particular is a valuable resource for doctors and their patients, particularly in rural and remote areas where it is difficultThis glossary term has not yet been described. to arrange faceThis glossary term has not yet been described.-to-face consultations with specialists. A teleconsultant can reply with provisional and differential diagnoses and a course of action, typically within 24 hours and without time zone difference constraints. Patients report high satisfaction with teledermatology, citing improved privacy and comfort and reduced waiting times [6][6].

Another major use of teledermatology is allowing primary care providers to appropriately triage patients who may need a face-to-face appointment with a specialist dermatologist. Teledermatology and dermoscopy can be more effective than traditional paper referrals in getting high-priority patients seen quickly [7][6], while also reducing unnecessary referrals to dermatologists [8][9].

Some studies assessing skin cancer have shown that diagnostic accuracy using teledermatology is comparable to face-to-face consultations, while others put teledermatology’s accuracy somewhat lower [6][10]; however, as for face-to-face consultations, adding dermoscopic images to a telemedicine consultation improves diagnostic accuracy considerably [11]Diagnostic accuracy is also less dependent on the quality of the image than on the level of diagnostic difficulty of the lesion and the expertise of the observer [12][13].

Mobile Teledermoscopy

Mobile teledermoscopyThis glossary term has not yet been described. involves using a magnifying lens with a polarised light that attaches to a mobile phone, allowing medical staff or patients to take dermoscopic-quality images with their smartphoneThis glossary term has not yet been described.. Images are then stored and forwarded to an expert dermatologist with an app. Mobile teledermoscopy may be particularly useful as an aid to skin self-examination for melanomaThis glossary term has not yet been described.: such aids have been shown to improve the frequency and sensitivity of skin self-examinations [14][15].

Pilot study participants have reported that mobile teledermoscopy is easy to perform [16][17] and motivates them to monitor their skin more often [18]; however, barriers to effective use include having many pigmented lesions, not having a partner to assist in imaging lesions on hard-to-reach places, or inadequate education about which lesions require attention.



References
  1. Finnane et al.: The growth of a skin emergency teledermatology service from 2008 to 2014. Australas. J. Dermatol. 2016;57:14-8. PMID: 26559493. DOI.
  2. Vega et al.: Testing a top-down strategy for establishing a sustainable telemedicine program in a developing country: the Arizona telemedicine program-US Army-Republic of Panama Initiative. Telemed J E Health 2013;19:746-53. PMID: 23931731. DOI.
  3. Tensen et al.: Two Decades of Teledermatology: Current Status and Integration in National Healthcare Systems. Curr Dermatol Rep 2016;5:96-104. PMID: 27182461. DOI.
  4. Dahl &: Briefing notes on maritime teledermatology. Int Marit Health 2014;65:61-4. PMID: 25231327. DOI.
  5. Hwang et al.: Utilization of telemedicine in the U.S. military in a deployed setting. Mil Med 2014;179:1347-53. PMID: 25373065. DOI.
  6. 6.0 6.1 6.2 6.3 Finnane et al.: Teledermatology for the Diagnosis and Management of Skin Cancer: A Systematic Review. JAMA Dermatol 2017;153:319-327. PMID: 27926766. DOI.
  7. Dahlén Gyllencreutz et al.: Diagnostic agreement and interobserver concordance with teledermoscopy referrals. J Eur Acad Dermatol Venereol 2017;31:898-903. PMID: 28150389. DOI.
  8. Eminović et al.: Teledermatologic consultation and reduction in referrals to dermatologists: a cluster randomized controlled trial. Arch Dermatol 2009;145:558-64. PMID: 19451500. DOI.
  9. van der Heijden et al.: Teledermatology applied following patient selection by general practitioners in daily practice improves efficiency and quality of care at lower cost. Br. J. Dermatol. 2011;165:1058-65. PMID: 21729026. DOI.
  10. Coates et al.: Teledermatology: from historical perspective to emerging techniques of the modern era: part II: Emerging technologies in teledermatology, limitations and future directions. J. Am. Acad. Dermatol. 2015;72:577-86; quiz 587-8. PMID: 25773408. DOI.
  11. Ferrándiz et al.: Internet-based skin cancer screening using clinical images alone or in conjunction with dermoscopic images: A randomized teledermoscopy trial. J. Am. Acad. Dermatol. 2017;76:676-682. PMID: 28089728. DOI.
  12. Piccolo et al.: Teledermoscopy--results of a multicentre study on 43 pigmented skin lesions. J Telemed Telecare 2000;6:132-7. PMID: 10912329. DOI.
  13. Piccolo et al.: Face-to-face diagnosis vs telediagnosis of pigmented skin tumors: a teledermoscopic study. Arch Dermatol 1999;135:1467-71. PMID: 10606051.
  14. Aneja et al.: Improvement in Patient Performance of Skin Self-examinations After Intervention With Interactive Education and Telecommunication Reminders: A Randomized Controlled Study. Arch Dermatol 2012;148:1266-72. PMID: 22911048. DOI.
  15. Hamidi et al.: Efficacy of skin self-examination for the early detection of melanoma. Int. J. Dermatol. 2010;49:126-34. PMID: 20465635. DOI.
  16. Janda et al.: Enhanced skin self-examination: a novel approach to skin cancer monitoring and follow-up. JAMA Dermatol 2013;149:231-6. PMID: 23426490. DOI.
  17. Wu et al.: Feasibility and Efficacy of Patient-Initiated Mobile Teledermoscopy for Short-term Monitoring of Clinically Atypical Nevi. JAMA Dermatol 2015;151:489-96. PMID: 25629626. DOI.
  18. Horsham et al.: Consumer acceptance of patient-performed mobile teledermoscopy for the early detection of melanoma. Br. J. Dermatol. 2016;175:1301-1310. PMID: 27037999. DOI.