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Journal of the Dermatology Nurses' Association

April 2010, Volume 2 Number 2 , p 81 - 82


  • Erin Dahlke


Warshaw, E. M., Lederle, F. A., Grill, J. P., Gravely, A. A., Bangerter, A. K., Fortier, L. A., et al. (2009). Accuracy of teledermatology for pigmented neoplasms. Journal of the American Academy of Dermatology, 61, 753-765.Teledermatology uses telecommunication technologies such as digital photography of skin lesions and dermoscopy to exchange medical information over a distance. This technology holds promise of providing cost-effective care to underserviced areas because clinicians can examine patients at remote sites. An important question is whether teledermatology is as accurate as a traditional face-to-face encounter.The authors of this trial compared the accuracy of teledermatology assessments and clinic dermatologist encounters for the same 542 patients (most of whom were White older male veterans). They compared the primary diagnosis, differential diagnoses, and management plans generated by both scenarios and judged the accuracy based on the histopathology of lesion biopsies.The authors found that the diagnostic accuracy of clinic dermatology assessments was superior to teledermatology assessments. The addition of dermatoscopic images did not significantly increase the diagnostic accuracy of teledermatology assessments. Of note, for a subgroup of 124 malignant pigmented lesions, there was a higher rate of inappropriate management in the teledermatology group, in which up to 7 of 36 melanomas would have been mismanaged if they had been assessed by teledermatology alone. The authors concluded that teledermatology should be used with caution for patients with suspected malignant pigmented lesions.REMARK: Teledermatology offers a new opportunity for providing dermatology care. As digital technology improves, teledermatology will continue to become a more available form of dermatologic assessment. This article reminds us that before widespread implementation can occur, rigorous evaluation of this technology is essential. Accurate diagnosis of pigmented lesions

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