Dermoscopic Photographs Impact Confidence and Management of Remotely Triaged Skin Lesions

Tova Rogers; Myles Randolph McCrary; Howa Yeung; Loren Krueger; Suephy Chen

doi:10.5826/dpc.1203a129

Dermoscopic Photographs Impact Confidence and Management of Remotely Triaged Skin Lesions

Authors

Tova Rogers Department of Dermatology, Emory University School of Medicine, Atlanta, GA
Myles Randolph McCrary Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia, USA
Howa Yeung Department of Dermatology, Emory University School of Medicine, Atlanta, GA; Regional Telehealth Service, VISN 7
Loren Krueger Department of Dermatology, Emory University School of Medicine, Atlanta, GA
Suephy Chen Regional Telehealth Service, VISN 7; Department of Dermatology, Duke University

Keywords:

telemedicine, teledermatology, dermoscopy, melanoma, skin cancer

Abstract

Background: Improving remote triage is crucial given expansions in teledermatology and with limited in-person care during COVID-19. In addition to clinical pictures, dermoscopic images may provide utility for triage.

Objective: To determine if dermoscopic photographs enhance confidence, triage accuracy, and triage prioritization for teledermatology.

Methods: In this parallel convergent mixed-methods study, a cohort of dermatologists and residents assessed skin lesions using clinical and dermoscopic photographs. For each case, participants viewed a clinical photograph and determined diagnostic category, management, urgency, and decision-making confidence. They subsequently viewed the associated dermoscopy and answered the same questions. A moderated focus group discussion followed to explore perceptions on the role of dermoscopy in teledermatology.

Results: Dermoscopy improved recognition of malignancies by 23% and significantly reduced triage urgency measures for non-malignant lesions. Participants endorsed specific utilities of teledermoscopy, such as for pigmented lesions, with limitations including poor image quality.

Conclusions: Dermoscopic photographs may be useful when remotely triaging skin lesions. Standardized imaging protocols are needed.

Author Biography

Suephy Chen, Regional Telehealth Service, VISN 7; Department of Dermatology, Duke University

All work performed while at Emory University

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