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Patient-led teledermoscopy appears feasible and effective


 

FROM JAMA DERMATOLOGY

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Patient-administered teledermoscopy using an iPhone-based mobile dermatoscope attachment and app is an effective and feasible method for short-term monitoring of clinically atypical nevi, with the added benefit of improving patient and physician convenience, based on data from a pilot study of 29 patients.

Researchers found a high level of diagnostic concordance (0.87) between dermatoscope images taken and assessed by an office-based dermatologist and those taken by the patient – albeit in the clinic setting – using the mobile dermatoscope and assessed by a teledermatologist.

All but one of the 29 patients with clinically atypical nevi who completed the study were able to acquire evaluable baseline and follow-up images, the researchers noted. In addition, most of the patients reported that the device was easy to use and that it saved them a trip to the doctor’s office. The study findings were published online Jan. 28 in JAMA Dermatology (doi:10.1001/jamadermatol.2014.3837).

“Under our modality of care, patients needing short-term monitoring will have an established relationship with their dermatologists, who will be the ones identifying concerning lesions that need to be monitored and the ones who evaluate the lesions via teledermoscopy and communicate treatment options directly with the patients,” wrote Xinyuan Wu of Memorial Sloan Kettering Cancer Center, New York, and colleagues.

The authors of an accompanying editorial wrote that recommendations for screening and follow-up for melanoma placed considerable burdens on patients, physicians, and the health care system, and that the patient-led mobile teledermoscopy described in the study was one of a number of options being considered to reduce that burden.

“The study by Wu and colleagues in this issue adds significantly to the discussion on whether regular follow-up visits with clinicians could be replaced by patient self-monitoring with remote feedback by a teledermatologist,” wrote Monika Janda, Ph.D., of the Queensland University of Technology in Brisbane, Australia, and colleagues.

One editorial author reported shares and consultancies with e-derm-consult GmbH and MoleMap, but there were no other conflicts of interest declared.

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