Dermoscopic Images Impact Confidence and Management of Remotely Triaged Skin Lesions: a Preliminary Study

• Type of Material: Article
• Authors: Tova Rogers, Emory University; Myles Randolph McCrary, Emory University; Howa Yeung, Emory University; Loren Krueger, Emory University; Suephy Chen, Emory University
• Language: English
• Date: 2022-07-01
• Publisher: Mattioli 1885 s.r.l.
• Publication Version: Final Published Version
• Copyright Statement: ©2022 Rogers et al
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.5826/dpc.1203a129
• Title of Journal or Parent Work: Dermatology Practical and Conceptual
• Volume: 12
• Issue: 3
• Start Page: e2022129
• End Page: e2022129
• Grant/Funding Information: None.
• Keywords: tele-dermatology; telemedicine; skin cancer; dermoscopy; melanoma
• Research Categories: Health Sciences, Oncology; Health Sciences, Medicine and Surgery

Abstract

Introduction: Improving remote triage is crucial given expansions in tele-dermatology and with limited in-person care during COVID-19. In addition to clinical pictures, dermoscopic images may provide utility for triage. Objectives: To determine if dermoscopic images enhance confidence, triage accuracy, and triage prioritization for tele-dermatology. Methods: In this preliminary parallel convergent mixed-methods study, a cohort of dermatologists and residents assessed skin lesions using clinical and dermoscopic images. For each case, participants viewed a clinical image and determined diagnostic category, management, urgency, and decisionmaking 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 tele-dermatology. Results: Dermoscopy improved recognition of malignancies by 23% and significantly reduced triage urgency measures for non-malignant lesions. Participants endorsed specific utilities of tele-dermoscopy, such as for evaluating pigmented lesions, with limitations including poor image quality. Conclusions: Dermoscopic images may be useful when remotely triaging skin lesions. Standardized imaging protocols are needed.