Feasibility and Efficacy of Patient-Initiated Mobile Teledermoscopy for Short-term Monitoring of Clinically Atypical Nevi

Abstract

Results from this pilot study suggest that teledermoscopy is feasible and effective as a method for short-term monitoring of clinically atypical nevi. The implementation of teledermoscopy can potentially enhance patient convenience, optimize physician scheduling, and promote efficiency.

Teledermatology: current perspectives

“…There was a predominance of female sex in six studies, 5,36,40,45,46,50 male predominance in two studies, 41,43 and no information about sex in nine studies. Participants' age also varied, ranging from infants to elderly patients.…”

“…7,36,37,40,[45][46][47][50][51][52] Twelve studies analyzed the reliability by kappa statistics. 5,36,[38][39][40][41][42][44][45][46]48,50 From these, one study compared teledermatology and FTF diagnosis to histopathological results, 39 one compared both groups to teledermatology and FTF diagnosis to the definitive diagnosis, 40 all the others considered FTF consultation as standard reference without histopathological confirmation for the diagnosis. In two studies focusing on reliability, teledermatology was used for advising another medical provider.…”

“…40 Of studies that compared telediagnosis to only FTF diagnosis, using kappa statistics, the overall diagnostic agreement between teledermatologists and FTF dermatologists showed high variability, from fair (kappa 0.35) 36 to almost perfect (kappa 0.91), 46 even though the majority of them (eight studies from 10) achieved substantial to almost perfect agreement. 5,38,41,42,[44][45][46]48,50 The agreement of management or therapy plan between both groups was only assessed by two studies, varying from moderate (kappa 0.57) 45 to almost perfect (kappa 0.86). 46 The intra-observer diagnostic reliability was investigated by three studies (kappa ranged from 0.49 to 0.69), 36,38,42 and the intra-observer management reliability by only one of them (kappa 0.58).…”

“…The possibility of secure transmission of medical data and images using different devices, in situations where a health professional and a patient (or two professionals) are not in the same location, and the strong visual component of dermatology make this strategy very useful, mostly for patients in remote areas. 1 It can be used for diagnosis, treatment, and follow-up of patients after a first dermatologist consultation, or to triage primary care cases and limit unnecessary referrals to dermatologists, [2][3][4][5][6] reducing social costs related to patient travel, such as productive working hours and transportation expenses.…”

Growth curve modeling of nevi displaying a peripheral globular pattern

“…Second, patients harboring these nevi should receive tailored counseling regarding the expected size evolution of these nevi to facilitate skin self-examination, prevent unnecessary skin biopsy, and possibly mollify patient anxiety. Although follow-up traditionally is performed in the office setting, Wu et al 16 recently showed that patients are capable of acquiring follow-up dermoscopic images and electronically submitting them to a teledermoscopist for evaluation. Nevus growth is a dynamic process influenced by a complex interplay of genetic and environmental factors.…”