Diagnostic accuracy and image quality using a digital camera for teledermatology

Objective: The study was designed to evaluate the effectiveness of digital photography for dermatologic diagnoses and compare it with in-person diagno ses. Materials and Methods: Patients referred for specialty consultations (n = 3 08) were recruited from a university dermatology clinic. Patients were exam ined in-person by one of three board-certified dermatologists who provided clinical diagnoses. Digital photos were obtained on all patients and were e valuated as computer images by a panel of dermatologists. Results: There was 83% concordance between in-person versus digital photo d iagnoses. Intradermatologist concordance averaged 84%, and interdermatologi st concordance averaged 81%. Decision confidence was rated as "very definit e" to "definite" 62% of the time. Concordance with biopsy results was achie ved in 76% of the cases. Image sharpness and color quality were rated "good " to "excellent" 83% and 93% of the time, respectively. Conclusion: Digital photography for store-and-forward teledermatology produ ces high-quality images and diagnostic concordance rates that compare favor ably with in-person clinical diagnoses.