A preliminary study of the contribution of telemicroscopy to the diagnosis and management of skin tumours in teledermatology

Abstract

Dermatology images can be acquired using a miniature handheld digital microscope at magnifications of 10- to 30-fold. We investigated the contribution of telemicroscopy to the reliability and accuracy of teledermatology for skin tumours. In a retrospective study of the reliability of diagnosis and management plans, two dermatologists compared teledermatology with face-to-face assessment. We also measured the accuracy of diagnosis by comparing teledermatology with histopathological examination. Two dermatologists evaluated the clinical images and information for 120 randomly sorted cases and recorded a diagnosis and a management plan for each case. Two months later, the same dermatologists re-evaluated the cases and suggested a new diagnosis and management plan for each case. The reliability of teledermatology diagnosis was not significantly different from face-to-face examination; it was significantly increased with the addition of microscopic images (P < 0.001). The reliability of teledermatology management plans was not significantly different from face-to-face examination; it was significantly increased with the addition of the microscopic images (P < 0.001). The accuracy of teledermatology was significantly increased with microscopic images (P = 0.05). Telemicroscopy appears to be a useful adjunct to teledermatology with a digital camera. Future studies with different magnifications should be performed to detect the optimum magnification for telemicroscopy.

Teledermatology for the Diagnosis and Management of Skin Cancer

“…These studies reported agreement between telediagnosis and the reference standard of 51% to 100%. 10,26,27,36 When separating malignant and benign lesions, telediagnoses of malignant lesions were histopathologically confirmed in 62% to 100% of cases, depending on the study. Of note, the study reporting 100% agreement between telediagnosis and histopathological diagnosis for malignant lesions only included 8 malignant lesions.…”

“…Eight studies (7 including dermoscopy) reported the diagnostic accuracy of teledermatology consultations 10,11,17,18,26,27,35,36 ( Table 4). Three of the 8 studies also assessed accuracy of FTF diagnosis compared with histopathological diagnosis, and compared the level of accuracy for FTF diagnoses with teledermatology diagnoses.…”

“…Three of the 8 studies also assessed accuracy of FTF diagnosis compared with histopathological diagnosis, and compared the level of accuracy for FTF diagnoses with teledermatology diagnoses. 11,17,35 Three studies assessing diagnostic accuracy of teledermatology using 133 to 188 clinical images (without dermoscopy) reported 68% to 85% agreement between teledermatology diagnosis and reference standard, 11,27 and sensitivity and specificity for detecting melanoma of 98% and 30%, respectively. 18 Five studies including dermoscopic or microscopic images of 69 to 613 lesions in teledermatology consultations reported agreement between 51% to 92% 11,27,35 (κ, 0.41-0.63), 17 and sensitivity and specificity for detecting melanoma of 96% and 62%, respectively.…”

“…11,17,35 Three studies assessing diagnostic accuracy of teledermatology using 133 to 188 clinical images (without dermoscopy) reported 68% to 85% agreement between teledermatology diagnosis and reference standard, 11,27 and sensitivity and specificity for detecting melanoma of 98% and 30%, respectively. 18 Five studies including dermoscopic or microscopic images of 69 to 613 lesions in teledermatology consultations reported agreement between 51% to 92% 11,27,35 (κ, 0.41-0.63), 17 and sensitivity and specificity for detecting melanoma of 96% and 62%, respectively. 10 One study reported very high sensitivity and specificity of teledermatology for both malignant melanocytic lesions (sensitivity, 100%; specificity, 97%-98%; n = 6) and malignant nonmelanocytic lesions (sensitivity, 97%; specificity, 92%-94%, n = 58), for both clinical and dermoscopic images (no significant differences between these methods).…”

Clinical, histopathological, dermatoscopic and digital microscopic features of dermatofibroma: a retrospective analysis of 200 lesions

“…Digital microscopy was previously used in dermatology practice for the evaluation of morphology of molluscum contagiosum and seborrhoeic keratosis. 17,18 S ßenel et al 19 recently reported that digital microscopy increased significantly the diagnostic and therapeutic reliability of teledermatologic application in skin tumours. As far as we are aware, the present study is preliminary to perform an evaluation of the digital microscopic features of dermatofibroma.…”