The contribution of teledermatoscopy to the diagnosis and management of non-melanocytic skin tumours

Abstract

We examined the contribution of dermatoscopy to the reliability of the diagnosis and management of non-melanocytic skin tumours using store-and-forward teledermatology. A total of 150 patients with non-melanocytic skin tumours were enrolled into the study. The reliability of the diagnoses and management plans was measured by comparing teledermatology with face-to-face examination; the effect of adding dermatoscopy images was also analysed. The accuracy of the diagnoses was measured by comparing teledermatology with histology; the effect of adding dermatoscopy images was also analysed. Diagnostic reliability (kappa) for teledermatology without dermatoscopy was 0.75 and 0.77 for two different dermatologists, A and B. The reliability increased significantly when dermatoscopy was added, to 0.86 and 0.88 respectively (P < 0.05). The reliability of management plans without dermatoscopy was 0.67 and 0.70, but it did not increase significantly when dermatoscopy was added. The accuracy of the diagnoses was significantly increased by the addition of dermatoscopic images, from 85% to 94% for dermatologist A and from 88% to 95% for dermatologist B. Teledermatology is a reliable technique for the diagnosis and management of non-melanocytic skin tumours and the addition of dermatoscopic images increases the reliability and the accuracy of teledermatology.