Teledermatology protocol for screening of skin cancer

An Bras Dermatol. 2015 Mar-Apr;90(2):202-10. doi: 10.1590/abd1806-4841.20153163.

Abstract

Background: Telemedicine refers to the use of technology as improvement of healthcare delivery to places where distance becomes an obstacle. Its use represents a great potential for dermatology, a specialty whose visual analysis phase is essential in diagnosis.

Objectives: To analyze the compatibility index of skin cancer diagnoses between primary care and teledermatology, and to validate a protocol for standardization of digital imaging to obtain the reports in teledermatology.

Methods: An observational cross-sectional study developed through the census of 333 examination requests, received between January/2012 and July/2012, in the Center for Telemedicine and Telehealth of SES-SC. We used a protocol for photographic lesion standardization, consisting of three steps (panoramic photo, close-up with ruler and dermoscopy). After collection, the data were sent to a virtual site on the Internet, and recorded with the use of an electronic health record containing the images, the skin phototype and demographic characteristics.

Results: The level of compatibility between the diagnosis of skin cancer in Santa Catarina's primary care and the diagnosis proposed by teledermatology was 19.02%. Proportionally, it was 21.21% for BCC, 44.44% for SCC and 6.98% for MM. The protocol was statistically significant (p <0.05), with an OR of 38.77.

Conclusion: The rate of diagnostic compatibility of skin cancer was low and the use of the protocol optimized the chance of validating requests for examination.

Publication types

  • Observational Study
  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Cross-Sectional Studies
  • Dermatology / methods
  • Dermatology / standards*
  • Female
  • Humans
  • Image Interpretation, Computer-Assisted / standards*
  • Male
  • Middle Aged
  • Observer Variation
  • Predictive Value of Tests
  • Primary Health Care / methods
  • Primary Health Care / standards*
  • Reproducibility of Results
  • Skin Neoplasms / diagnosis*
  • Telemedicine / methods
  • Telemedicine / standards*
  • Telepathology / methods
  • Telepathology / standards