Analysis of Teledermoscopy and Face-to-Face Examination of Atypical Pigmented Lesions: a Cross-Sectional, Retrospective Study
Keywords:
dermoscopy, dysplastic naevi, melanoma, telemedicineAbstract
Introduction: Malignant melanoma (MM) is one of the most fatal skin cancers. Early detection and treatment are crucial for metastasis prevention. The growing number of MM cases has led to an increased need for skin examinations, increasing the healthcare demand in dermatology departments.
Objectives: The purpose of this cross-sectional, retrospective study was to analyze the accuracy and reliability of two different methods, teledermoscopy (TD) and face-to-face examination (FTF), with two different patient groups for MM detection in Jönköping County.
Methods: In teledermoscopic evaluation, a general practitioner takes photographs of a suspected skin lesion (clinical and dermoscopic images) and sends TD referrals to a dermatologist for digital assessment. In the FTF group, the diagnosis was made during regular clinical visits to the dermatology department by a dermatologist.
Results: The TD group comprised 55 women and 57 men, and an FTF group comprised 72 women and 66 men. Based on the histopathology report, in the TD group, 75% of suspected MM lesions were accurately classified as MM compared with 57% of suspected MM lesions correctly diagnosed in the FTF group. When compared with histopathology report, the diagnostic concordance of TD and FTF examinations were 80% and 69%, respectively.
Conclusions: We report a high diagnostic concordance between TD and the final histopathological diagnosis. Metrics analyzed for diagnostic accuracy confirmed that TD is an effective and accurate method for early diagnosis of MM. TD is suitable, non-inferior and a useful alternative to FTF examination.
References
AAbbas O, Miller DD, Bhawan J. Cutaneous malignant melanoma: update on diagnostic and prognostic biomarkers. Am J Dermatopathol. 2014;36(5):363-379. DOI: 10.1097/DAD.0b013e31828a2ec5. PMID: 24803061.
Tan E, Levell NJ. Regular clinical dermatoscope use with training improves melanoma diagnosis by dermatologists. Clin Exp Dermatol. 2009;34(8):e876-e878. DOI: 10.1111/j.1365-2230.2009.03629.x. PMID: 20055853.
Hartman RI, Lin JY. Cutaneous Melanoma-A Review in Detection, Staging, and Management. Hematol Oncol Clin North Am. 2019;33(1):25-38. DOI: 10.1016/j.hoc.2018.09.005. PMID: 30497675.
LLee KJ, Finnane A, Soyer HP. Recent trends in teledermatology and teledermoscopy. Dermatol Pract Concept. 2018;8(3):214-223. DOI: 10.5826/dpc.0803a13. PMID: 30116667. PMCID: PMC6092076.
Markun S, Scherz N, Rosemann T, Tandjung R, Braun RP. Mobile teledermatology for skin cancer screening: A diagnostic accuracy study. Medicine (Baltimore). 2017;96(10):e6278. DOI: 10.1097/MD.0000000000006278. PMID: 28272243. PMCID: PMC5348191.
Lee KJ, Finnane A, Soyer HP. Recent trends in teledermatology and teledermoscopy. Dermatol Pract Concept. 2018;8(3):214-223. DOI: 10.5826/dpc.0803a13. PMID: 30116667. PMCID: PMC6092076.
Lee JJ, English JC 3rd. Teledermatology: A Review and Update. Am J Clin Dermatol. 2018;19(2):253-260. DOI: 10.1007/s40257-017-0317-6. PMID: 28871562.
Warshaw EM, Lederle FA, Grill JP, et al. Accuracy of teledermatology for nonpigmented neoplasms. J Am Acad Dermatol. 2009;60(4):579-588. DOI: 10.1016/j.jaad.2008.11.892. PMID: 19217689.
Warshaw EM, Lederle FA, Grill JP, et al. Accuracy of teledermatology for pigmented neoplasms. J Am Acad Dermatol. 2009;61(5):753-765. DOI:10.1016/j.jaad.2009.04.032. PMID: 19679375.
Ingvar C, Eriksson H. Varannan timme får en svensk ett nytt malignt melanom - Incidens, utfall och prevention [Every second hour there is a new melanoma diagnosed in Sweden]. Lakartidningen. 2017;114:ELAT. PMID: 28485768.
Deeks JJ, Altman DG. Diagnostic tests 4: likelihood ratios. BMJ. 2004;329(7458):168-169. DOI: 10.1136/bmj.329.7458.168. PMID: 15258077. PMCID: PMC478236.
OObuchowski NA, Lieber ML, Wians FH Jr. ROC curves in clinical chemistry: uses, misuses, and possible solutions. Clin Chem. 2004;50(7):1118-1125. DOI: 10.1373/clinchem.2004.031823. PMID: 15142978.
Raslich MA, Markert RJ, Stutes SA. Selecting and interpreting diagnostic tests. Biochem Med (Zagreb). 2007;17(2):151-161. DOI:10.11613/BM.2007.014
M Marchetti A, Dalle S, Maucort-Boulch D, et al. Diagnostic Concordance in Tertiary (Dermatologists-to-Experts) Teledermoscopy: A Final Diagnosis-Based Study on 290 Cases. Dermatol Pract Concept. 2020;10(3):e2020071. DOI: 10.5826/dpc.1003a71. PMID: 32642316: PMCID: PMC7319786.
Dahlén Gyllencreutz J, Paoli J, Bjellerup M, et al. Diagnostic agreement and interobserver concordance with teledermoscopy referrals. J Eur Acad Dermatol Venereol. 2017;31(5):898-903. DOI:10.1111/jdv.14147. PMID: 28150389.
Lozzi GP, Soyer HP, Massone C, et al. The additive value of second opinion teleconsulting in the management of patients with challenging inflammatory, neoplastic skin diseases: a best practice model in dermatology? J Eur Acad Dermatol Venereol. 2007;21(1):30-34. DOI:10.1111/j.1468-3083.2006.01846.x. LPMID: 17207164.
Jones L, Jameson M, Oakley A. Remote Skin Cancer Diagnosis: Adding Images to Electronic Referrals Is More Efficient Than Wait-Listing for a Nurse-Led Imaging Clinic. Cancers (Basel). Nov 20 2021;13(22)doi:10.3390/cancers13225828. Jones L, Jameson M, Oakley A. Remote Skin Cancer Diagnosis: Adding Images to Electronic Referrals Is More Efficient Than Wait-Listing for a Nurse-Led Imaging Clinic. Cancers (Basel). 2021 Nov 20;13(22):5828. doi: 10.3390/cancers13225828. PMID: 34830982; PMCID: PMC8616500.
Wang M, Gendreau JL, Gemelas J, et al. Diagnosis and Management of Malignant Melanoma in Store-and-Forward Teledermatology. Telemed J E Health. 2017;23(11):877-880. DOI:10.1089/tmj.2017.0009. PMID: 28498031.
Ishioka P, Tenório JM, Lopes PR, et al. A comparative study of teledermatoscopy and face-to-face examination of pigmented skin lesions. J Telemed Telecare. 2009;15(5):221-225. DOI:10.1258/jtt.2009.081107. PMID: 19590026.
Börve A, Terstappen K, Sandberg C, Paoli J. Mobile teledermoscopy-there's an app for that! Dermatol Pract Concept. 2013;3(2):41-48. DOI:10.5826/dpc.0302a05. PMID: 23785643. PMCID: PMC3663402.
van der Heijden JP, Thijssing L, Witkamp L, Spuls PI, de Keizer NF. Accuracy and reliability of teledermatoscopy with images taken by general practitioners during everyday practice. J Telemed Telecare. 2013;19(6):320-325. DOI:10.1177/1357633x13503437. PMID: 24163296.
Silveira CE, Silva TB, Fregnani JH, et al. Digital photography in skin cancer screening by mobile units in remote areas of Brazil. BMC Dermatol. 2014;14:19. DOI:10.1186/s12895-014-0019-1. PMID: 25539949. PMCID: PMC4302445.
Finnane A, Dallest K, Janda M, Soyer HP. Teledermatology for the Diagnosis and Management of Skin Cancer: A Systematic Review. JAMA Dermatol. 2017;153(3):319-327. DOI:10.1001/jamadermatol.2016.4361. PMID: 27926766.
Tan E, Oakley A, Soyer HP, et al. Interobserver variability of teledermoscopy: an international study. Br J Dermatol. 2010;163(6):1276-1281. DOI: 10.1111/j.1365-2133.2010.10010.x. PMID: 20795998.
Vestergaard T, Prasad SC, Schuster A, Laurinaviciene R, Andersen MK, Bygum A. Diagnostic accuracy and interobserver concordance: teledermoscopy of 600 suspicious skin lesions in Southern Denmark. J Eur Acad Dermatol Venereol. 2020;34(7):1601-1608. DOI:10.1111/jdv.16275. PMID: 32031277.
Published
Issue
Section
License
Copyright (c) 2023 Nor Fazil Jaber, Sandra Jerkovic Gulin, Oliver Seifert
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Dermatology Practical & Conceptual applies a Creative Commons Attribution License (CCAL) to all works we publish (http://creativecommons.org/licenses/by-nc/4.0/). Authors retain the copyright for their published work.
How to Cite
Share
