Part I: Accuracy of Teledermatology in Inflammatory Dermatoses

Abstract

Teledermatology is assuming a progressively greater role as a healthcare delivery method, especially now, during this pandemic time. It is important to know how accurate this tool is for different skin diseases. Most of the studies have focused on skin neoplasms or general dermatology. Studies based on a large number of inflammatory dermatoses have not yet been performed. Such knowledge can help dermatologists to decide whether endorsing this method or not. Our objective was to determine the accuracy of teledermatology in inflammatory dermatoses in a robust number of cases. A retrospective cohort study was conducted in São Paulo, Brazil, from July 2017-18, where a store-and-forward Teledermatology project was implemented under primary-care attention to triage surgical, more complex, or severe dermatoses. A total of 30,976 patients presenting 55,012 lesions took part in the project. Thirteen participating teledermatologists had three options to refer the patients: directly to biopsy, to the inperson dermatologist or back to the general physician with most probable diagnosis and management. In the group referred to the in-person dermatologist, we looked for the 20 most frequent International Classification of Diseases and Related Health Problems-10th revision (ICD-10) of inflammatory dermatoses, which resulted in 739 patients and 739 lesions. As patients had been triaged by teledermatology previously, we were able to compare ICD-10 codes filled both by teledermatogists and by in-person dermatologists. The proportion of complete, partial, and no agreement rates between the in-person dermatologist's and the teledermatologist's diagnoses was used for accuracy. We also calculated Cohen's kappa, a statistical measure of inter-rater agreement, for complete agreement. The mean complete agreement rate for all twenty dermatoses was 78% (31-100%) and kappa = 0.743; partial agreement 8%; and no agreement 14%, presenting variability according to the disease. Our study showed that teledermatology for inflammatory dermatoses has a high accuracy. This result reassures that it can be a proper option for patient care.

Teledermatology during the COVID ‐19 pandemic: Experience at a tertiary care centre in North India

“…[12][13][14] Two retrospective studies from Brazil reported high degree of accuracy with teledermatology in inflammatory dermatoses and moderate accuracy for neoplasms. 15,16 High levels of satisfaction with teleservices has been reported previously in patients having acne. 17 In this study, 62% of acne patients reported being satisfied or very satisfied with teleconsultation services.…”

“…[12][13][14] Two retrospective studies from Brazil reported high degree of accuracy with teledermatology in inflammatory dermatoses and moderate accuracy for neoplasms. 15,16 High levels of satisfaction with teleservices has been reported…”

Teledermatologie: Fluch oder Segen?

“…Die Dermatologie hat sich für die Implementierung solcher Technologien aufgrund ihres hauptsächlich visuell orientierten Charakters bei der Diagnosestellung als ideales ärztliches Fach erwiesen. Zwar unterscheidet sich die diagnostische Trefferquote zwischen Studien, mehrheitlich wurden jedoch korrekte Diagnoseraten von 75-80% geschätzt, die vergleichbar der Präsenzvorstellung sind [11,12]. Für eine teledermatologische Betreuung gut geeignete Hauterkrankungen sind u. a. Akne vulgaris, atopische Dermatitis, Psoriasis, seborrhoische Dermatitis, bullöses Pemphigoid, Tinea pedis, Onychomykose und Xerosis cutis [13,14].…”

Evaluation of High‐Efficiency Image Coding algorithm for dermatology images in teledermatology

“…Today, with digital cameras, it is possible to store high-quality images and transmit them without distortion at a significantly lower cost, dramatically compared to a standard camera. 13 On the other hand, the increase in the number and quality of images, besides electronic devices limitation-storage capacities and data transfer bandwidth-have prompted engineers and image experts to find a way to address this challenge. Various algorithms can achieve this goal, which is defined as "image compression techniques".…”