title: Teledermatology protocol for screening of skin cancer.
abstract: BACKGROUND
  Telemedicine refers to the use of technology as improvement of healthcare delivery to places where distance becomes an obstacle. Its use represents a great potential for dermatology, a specialty whose visual analysis phase is essential in diagnosis.
  
  
  OBJECTIVE
  To analyze the compatibility index of skin cancer diagnoses between primary care and teledermatology, and to validate a protocol for standardization of digital imaging to obtain the reports in teledermatology.
  
  
  METHODS
  An observational cross-sectional study developed through the census of 333 examination requests, received between January/2012 and July/2012, in the Center for Telemedicine and Telehealth of SES-SC. We used a protocol for photographic lesion standardization, consisting of three steps (panoramic photo, close-up with ruler and dermoscopy). After collection, the data were sent to a virtual site on the Internet, and recorded with the use of an electronic health record containing the images, the skin phototype and demographic characteristics.
  
  
  RESULTS
  The level of compatibility between the diagnosis of skin cancer in Santa Catarina's primary care and the diagnosis proposed by teledermatology was 19.02%. Proportionally, it was 21.21% for BCC, 44.44% for SCC and 6.98% for MM. The protocol was statistically significant (p <0.05), with an OR of 38.77.
  
  
  CONCLUSIONS
  The rate of diagnostic compatibility of skin cancer was low and the use of the protocol optimized the chance of validating requests for examination.
authors.affiliation: Universidade do Sul de Santa Catarina, Palhoça, SC, Brazil.
authors.forename: Maria Fernanda
authors.initials: MF
authors.lastname: Piccoli
authors.affiliation: Universidade do Sul de Santa Catarina, Palhoça, SC, Brazil.
authors.forename: Bruna Dücker Bastos
authors.initials: BD
authors.lastname: Amorim
authors.affiliation: Fundação de Ensino e Engenharia de Santa Catarina, Florianópolis, SC, Brazil.
authors.forename: Harley Miguel
authors.initials: HM
authors.lastname: Wagner
authors.affiliation: Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil.
authors.forename: Daniel Holthausen
authors.initials: DH
authors.lastname: Nunes
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003880:Dermatology / Q000379:methods / Q000592:standards*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000592:standards*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D011320:Primary Health Care / Q000379:methods / Q000592:standards*; D015203:Reproducibility of Results; D012878:Skin Neoplasms / Q000175:diagnosis*; D017216:Telemedicine / Q000379:methods / Q000592:standards*; D019113:Telepathology / Q000379:methods / Q000592:standards
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