COMPARISON OF CONVENTIONAL PHOTOGRAPHS AND TELEPHONICALLY TRANSMITTEDCOMPRESSED DIGITIZED IMAGES OF MELANOMAS AND DYSPLASTIC NEVI

Background: One of the most difficult problems in the in vivo diagnosi s of cutaneous tumors is the differentiation clinically between early malignant melanoma (MM) and atypical (dysplastic) melanocytic nevi (AM Ns) because these lesions share clinical features. High-quality digita l imaging systems and store- and-forward technology have the potential for use in a teledermatology system with which experts would be able to immediately transmit their diagnostic opinions ions concerning thes e challenging lesions. Objective: The main purpose of this study was t o determine if the clinical and dermoscopic diagnoses and the dermosco pic features of AMN and early MM are unaltered after telephonic transm ission of their digitized images. Methods: Conventional and dermoscopi c photographic transparencies of 22 AMNs and 9 early MMs, viewed on re arview projectors and then scanned, compressed, transmitted (Internet) and viewed on color monitors, were evaluated. Results: The concordanc e in the diagnosis of AMN and of early MM by all four observers, both clinically and dermoscopically, when comparing rearview-projected conv entional transparency slides to transmitted, compressed, digitized ima ges, was high. For most specific dermoscopic features, the concordance was good, although less so for the presence or absence of some dermos copic features, namely 'dots', 'blue/gray' color and 'red' color. Conc lusion: The results reported support the conclusion chat Internet tran smission of digitized images of MMs and AMNs retains sufficient inform ativeness for diagnostic purposes. This study is a step in the creatio n of an international teledermoscopy network for pigmented cutaneous l esions.