Teledermatology: An Update

Dermatology is perhaps the most visual specialty in medicine, making it ideally suited for
modern telemedicine techniques, as has been shown in a number of recent studies
investigating feasibility and reliability of teledermatology. It has generally demonstrated
high levels of concordance in diagnosis and management plans compared with face-to-face
consultations. Teledermatology also has been used for various purposes, including triage,
diagnostic and management services, and second-opinion services for primary care practitioners.
It has been set up in a number of ways: (1) direct referral for primary care using
images and clinical history sent to secondary care dermatology services for second opinion
and for triage referrals and (2) facilitating community-based clinics led by nurses or general
practitioners. Moreover, in the last years new fields in teledermatology have grown up.
Teledermoscopy is a promising area for melanoma screening as well as for the diagnosis
and management of equivocal pigmented skin lesions. The feasibility of mobile teledermatology
and mobile teledermoscopy recently has been proven, and these new facilities have
the potential to become an easy applicable tool for everyone and may open the door for a
new flexible triage system for detection of skin cancer in general and melanoma in
particular. The implementation of virtual slide systems for teledermatopathology has allowed
avoiding the limitations imposed by conventional microphotography. Finally, web
consultations in dermatology are a rather new tool that became available in the last years
and teledermatologic services through the Internet offer many possibilities, including
continuing medical education, on-line atlases and databases, and specific web application
suited for teledermatology (ie, www.telederm.org).
Semin Cutan Med Surg 27:101-105 © 2008 Elsevier Inc. All rights reserved.

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