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SUMMARY
Teledermatology is a currently expanding field with the potential to improve health care access and costs worldwide, reduce wait times for face-to-face dermatology visits, minimize unnecessary visits, and expedite critical diagnoses.
Teledermatology is comparable to face-to-face visits in diagnostic accuracy of melanoma and nonmelanoma skin cancer.
Teledermoscopy may hold the key to transforming teledermatology from a tool of triage to a management strategy.
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DON’T FORGET
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CLINICAL PEARLS
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PATIENT EDUCATION POINTS
Patients should be educated on the proper use of direct-to-patient/consumer (teledermatologic mobile applications, which do not include app-based diagnoses or advice on clinical management.
U.S. Preventative Services Task Force guidelines on skin screening conclude that there is insufficient evidence currently to assess the risk versus benefit of visual skin cancer screening by clinicians.
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Telemedicine is distinctly applicable to the field of dermatology because the majority of skin is visible to the naked eye and dermatologic diagnoses are often made without elaborate laboratory testing or internal imaging. Teledermatology is defined as the remote provision of dermatologic patient care via telecommunication.1 Teledermatology is an expanding field with the potential to improve health care access, costs, reduce wait times for face-to-face (FTF) dermatology visits, minimize unnecessary FTF visits, and expedite critical diagnoses. Significant factors that improve the quality of teledermatology include proper image quality, dermatologist confidence in sharing medical advice online, the introduction of teledermoscopy, and the proficiency of the dermatologist regarding skill level and training in telemedicine.2
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Telemedicine dates back to the 18th century when the sick would write letters to be delivered by courier to physicians who would reply with a diagnosis and treatment plan, including written prescriptions.3 The first mention of telemedicine in a PubMed article was in 1974,4 and discussion of teledermatology in the literature first occurred in 1995.5 The first remote dermatologic assessment occurred during the 1992 Department of Defense “Operation Restore Hope” relief mission in Somalia, where 74 teledermatology consultations for deployed troops were conducted that year.6 As computers and mobile phones have evolved to become more accessible and advanced, the field of teledermatology has since expanded to widespread use in all 50 states plus Puerto Rico.7
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Teledermatology has improved the timeliness and accuracy of cancer diagnoses worldwide, including melanoma, keratinocyte carcinomas (basal cell carcinoma and squamous cell carcinoma), and other pigmented and nonpigmented lesions.8,9 The importance of early diagnosis of melanoma and nonmelanoma skin cancers is widely understood. The prevalence of keratinocyte carcinomas far surpasses the prevalence of all ...