title: Dermatopathology via a still-image telemedicine system: diagnostic concordance with direct microscopy.
abstract: OBJECTIVE
  To determine the concordance of dermatopathology diagnosis by still-image telemedicine technology and direct microscopy.
  
  
  METHODS
  Skin specimens (N = 79) were examined by a dermatopathologist using a still-image phone system, and the diagnoses were compared with those made by the same dermatopathologist 1 year earlier by direct microscopy. The telemedical diagnoses were reached first without, and then with, patient histories.
  
  
  RESULTS
  When the patient history was available, identical diagnoses were made in 66 of the 79 cases (84% concordance rate). Without patient history, the concordance rate was 80%. The diagnostic concordance rate for the diagnosis of benign nevocytic nevi, inflammatory diseases, and benign and malignant non-squamous cell carcinoma neoplasms was statistically significantly greater than the concordance rate for the diagnosis of squamous cell carcinoma and squamous cell carcinoma in situ (P = 0.005).
  
  
  CONCLUSIONS
  The diagnostic concordance rate achieved by teledermatopathology using a still-image phone system fell short of the 99% intraobserver diagnostic concordance rate using direct microscopy.
authors.affiliation: Dept. of Dermatology, University of Miami School of Medicine, FL 33136, USA.
authors.forename: B
authors.initials: B
authors.lastname: Berman
authors.forename: G W
authors.initials: GW
authors.lastname: Elgart
authors.forename: A E
authors.initials: AE
authors.lastname: Burdick
mesh_terms: D006801:Humans; D008853:Microscopy; D012867:Skin / Q000473:pathology*; D012871:Skin Diseases / Q000175:diagnosis*; D019113:Telepathology