Recent trends in teledermatology and teledermoscopy

Abstract

Teledermatology is a useful alternative where specialized dermatological assistance is not available and has been used successfully to support health professionals in a wide range of settings worldwide, in either an asynchronous store-and-forward format or a real-time video conferencing format. Teledermoscopy, which includes dermoscopic images in the teleconsultation, is another addition that improves remote assessments of pigmented lesions. A more recent variant is mobile teledermoscopy, which uses a smartphone to deliver the same type of service. Teledermoscopy's greatest strength may be as a triage and monitoring tool, as it can reduce the number of unnecessary referrals, wait times, and the cost of providing and receiving dermatological care. While face-to-face (FTF) care remains the gold standard for diagnosis, drawbacks of not using FTF care as the primary method can be mitigated if teleconsultants are willing to refer to FTF care whenever there is uncertainty. Teledermatology has generally been well accepted by patients and practitioners alike. Barriers to the large-scale use of teledermatology remain. Assigning medicolegal responsibility and instituting a reimbursement system are critical to promoting widespread use by medical professionals, while privacy and security features and a mechanism to link teleconsultations to patients' existing health records are essential to maximize patient benefit. Direct-to-consumer services also need attention from regulators to ensure that consumers can enjoy the benefits of telemedicine without the dangers of unregulated or untested platforms.

Keywords: melanoma; mobile teledermoscopy; skin cancer; teledermatology; teledermoscopy.

Figure 1

A dermoscopic image provides greater clarity and detail for melanocytic lesions. [Copyright: ©2018 Lee et al.]

Figure 2

Sequential monitoring of a clinically dysplastic nevus using the MoleMap teledermoscopy platform. The 2 larger images in the top row compare dermoscopic images of the same lesion taken 4 years apart. The images in the middle row are clinical images of the same lesions taken over 4 years, and the images in the bottom row are the corresponding dermoscopic images. (Supplied by authors; H. Peter Soyer is a shareholder and consultant of MoleMap Pty Ltd.) [Copyright: ©2018 Lee et al.]

Figure 3

Mobile teledermoscopy with a Handyscope dermoscopic attachment (FotoFinder Systems GmbH, Bad Birnbach, Germany). [©2018 FotoFinder Systems]