In-Office Visit Offers Benefits Compared to Teledermatology

In-person diagnosis of lesions superior to teledermatology; management plans were similar

THURSDAY, April 23 (HealthDay News) -- In general, the use of teledermatology resulted in poorer diagnostic accuracy when evaluating nonpigmented lesions than clinic-based dermatology, according to research published in the April issue of the Journal of the American Academy of Dermatology.

Erin M. Warshaw, M.D., of the Minneapolis Veterans Affairs Medical Center, and colleagues analyzed data from 728 subjects with nonpigmented skin neoplasms, nearly all of whom were male and white. An in-person dermatologist and a teledermatologist evaluated each lesion, the latter assessing electronically transmitted macro images with or without polarized light dermatoscopy (PLD), along with patient and lesion history. Each produced a primary diagnosis, up to two differential diagnoses, and a management plan.

In terms of aggregated diagnostic accuracy (the agreement of one of the diagnoses with histopathology results), teledermatology was inferior to in-person assessments. However, the groups generated management plans that were equivalent in accuracy. In teledermatology, diagnostic accuracy was better with PLD than macro images alone.

"For the important subgroup of malignant lesions, the addition of PLD images significantly improved teledermatology aggregated diagnostic accuracy rates yielding equivalency with clinic dermatology. Although diagnostic accuracy of teledermatology was inferior to standard clinical dermatology, this study confirms the clinical utility of teledermatology for management of nonpigmented lesions and underscores the important role of PLD images for diagnosis of malignant nonpigmented lesions," the authors conclude.

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