Face-to-face diagnosis vs telediagnosis of pigmented skin tumors: a teledermoscopic study.
BACKGROUND
Teledermoscopy uses telecommunication technologies to transfer images of pigmented skin lesions, including clinical and anamnestic data, via e-mail to specialized centers for teleconsultation.


METHODS
Sixty-six pigmented skin lesions examined on a face-to-face basis in a skin lesion clinic in L'Aquila, Italy, were sent via e-mail on a standard-resolution color monitor for consultation at a university dermatology department in Graz, Austria.


METHODS
Digital photographs of the clinical and dermoscopic images of all pigmented tumors were taken with a stereomicroscope connected to a high-resolution video camera in Truevision advanced graphic array (Targa) format file and converted successively into a Joint Photographic Expert Group (PEG) format file. All lesions were excised surgically and diagnosed histopathologically.


METHODS
Diagnostic concordance between face-to-face diagnosis and telediagnosis.


RESULTS
The diagnostic concordance was 60 (91%) of 66 cases. The number of correct telediagnoses was lower, but the difference was not statistically significant (Wilcoxon test, P = .10). The accuracy of the telediagnoses was not related to the quality of the images, but highly depended on the level of diagnostic difficulty of a given pigmented skin tumor (Spearman correlation, P= .01).


CONCLUSIONS
Teleconsultation of clinical and dermoscopic images of skin tumors via e-mail provides a similar degree of diagnostic accuracy as face-to-face diagnosis.
Piccolo
D
D
Department of Dermatology, University of L'Aquila, Italy.
Smolle
J
J
Wolf
I H
IH
Peris
K
K
Hofmann-Wellenhof
R
R
Dell'Eva
G
G
Burroni
M
M
Chimenti
S
S
Kerl
H
H
Soyer
H P
HP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003937:Diagnosis, Differential; D019723:Endoscopes; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation*; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000473:pathology; D008875:Middle Aged; D009508:Nevus, Pigmented / Q000175:diagnosis* / Q000473:pathology; D010348:Patient Care Team; D019114:Remote Consultation; D012680:Sensitivity and Specificity; D012867:Skin / Q000473:pathology; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000473:pathology; D014741:Video Recording / Q000295:instrumentation*