title: Teledermoscopy in High-risk Melanoma Patients: A Comparative Study of Face-to-face and Teledermatology Visits.
abstract: Teledermoscopy is considered a reliable tool for the evaluation of pigmented skin lesions. We compared the management decision in face-to-face visits vs. teledermatology in a high-risk melanoma cohort using total-body photography, macroscopic and dermoscopic images of single lesions. Patients were assessed both face-to face and by 4 remote teledermatologists. Lesions identified as suspicious for skin cancer by face-to-face evaluation underwent surgical excision. The teledermatologists recommended "self-monitoring", "short-term monitoring", or "excision". A 4-year monitoring was completed in a cohort of participating subjects. The general agreement, calculated by prevalence and bias-adjusted κ (PABAK), showed almost perfect agreement (PABAK 0.9-0.982). A total of 23 lesions were excised; all teledermatologists identified the 9 melanomas. The greatest discrepancy was detected in "short-term monitoring". During 4-year monitoring one melanoma was excised that had been considered benign. In conclusion, melanoma identification by experts in pigmented lesions appears to be equivalent between face-to-face and teledermatological consultation.
authors.affiliation: Department of Dermatology, Medical University of Graz, Graz, Austria. edith.arzberger@medunigraz.at.
authors.forename: Edith
authors.initials: E
authors.lastname: Arzberger
authors.forename: Clara
authors.initials: C
authors.lastname: Curiel-Lewandrowski
authors.forename: Andreas
authors.initials: A
authors.lastname: Blum
authors.forename: Dmitry
authors.initials: D
authors.lastname: Chubisov
authors.forename: Amanda
authors.initials: A
authors.lastname: Oakley
authors.forename: Marius
authors.initials: M
authors.lastname: Rademaker
authors.forename: Hans
authors.initials: H
authors.lastname: Soyer
authors.forename: Rainer
authors.initials: R
authors.lastname: Hofmann-Wellenhof
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria; D002648:Child; D046169:Dermoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000601:surgery; D008875:Middle Aged; D010781:Photography; D019114:Remote Consultation; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000601:surgery