Face-to-face diagnosis vs telediagnosis of pigmented skin tumors - A teledermoscopic study

Background: Teledermoscopy uses telecommunication technologies to transfer images of pigmented skin lesions, including clinical and anamnestic data, v ia email to specialized centers for teleconsultation. Design: Sixty-six pigmented skin lesions examined on a face-to-face basis i n a skin lesion clinic in L'Aquila, Italy, were sent via e-mail on a standa rd-resolution color monitor for consultation at a university dermatology de partment in Graz, Austria. Intervention: Digital photographs of the clinical and dermoscopic images of all pigmented tumors were taken with a stereomicroscope connected to a hig h-resolution video camera in Truevision advanced graphic array (Targa) form at file and converted successively into a Joint Photographic Expert Group ( JPEG) format file. All lesions were excised surgically and diagnosed histop athologically. Main Outcome Measurer Diagnostic concordance between face-to-face diagnosis and telediagnosis. Results: The diagnostic concordance was 60 (91%) of 66 cases. The number of correct telediagnoses was lower, but the difference was not statistically significant (Wilcoxon test, P = .10). The accuracy of the telediagnoses was not related to the quality of the images, but highly depended on the level of diagnostic difficulty of a given pigmented skin tumor (Spearman correla tion, P = .01). Conclusion: Teleconsultation of clinical and dermoscopic images of skin tum ors via e-mail provides a similar degree of diagnostic accuracy as face-to- face diagnosis.