Insights, Advantages, and Barriers of Teledermatology vs. Face-to-Face Dermatology for the Diagnosis and Follow-Up of Non-Melanoma Skin Cancer: A Systematic Review

Author:

Nikolakis Georgios12ORCID,Vaiopoulos Aristeidis G.3ORCID,Georgopoulos Ioannis24,Papakonstantinou Eleni5,Gaitanis George6ORCID,Zouboulis Christos C.1ORCID

Affiliation:

1. Departments of Dermatology, Venereology, Allergology and Immunology, Staedtisches Klinikum Dessau, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, 06847 Dessau, Germany

2. Docandu Ltd., London Ν8 0ES, UK

3. Second Department of Dermatology and Venereology, “Attikon” University General Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece

4. Surgical Department, “Agia Sofia” Children’s Hospital, 11527 Athens, Greece

5. Private Practice of Dermatology, 19100 Attiki, Greece

6. Department of Skin and Venereal Diseases, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece

Abstract

Background: Teledermatology is employed in the diagnosis and follow-up of skin cancer and its use was intensified during and after the COVID-19 pandemic. At the same time, demographic changes result in an overall increase in non-melanoma skin cancer and skin precancerous lesions. The aim of this study was to elucidate the role of teledermatology in comparison to conventional face-to-face dermatology for such lesions and determine the advantages and limitations of this workflow for patients and physicians. Methods: Research was performed using relevant keywords in MEDLINE and CENTRAL. Relevant articles were chosen following a predetermined standardized extraction form. Results: Diagnostic accuracy and interrater/intrarater agreement can be considered comparable—although lower—than in-person consultation. Improvement of particular features such as image quality, medical history availability, and teledermoscopy can further increase accuracy. Further aspects of limitations and advantages (mean time-to-assessment, time-to-treatment, cost-effectiveness) are discussed. Conclusions: Teledermatology has comparable diagnostic accuracy with face-to-face dermatology and can be utilized both for the effective triage of non-melanocytic epithelial tumors and precancerous lesions, as well as the follow-up. Easy access to dermatologic consultation with shorter mean times to diagnostic biopsy and/or treatment coupled with cost-effectiveness could compensate for the lower sensitivity of teledermatology and offer easier access to medical care to the affected populations.

Publisher

MDPI AG

Reference43 articles.

1. Position Paper: Telemedicine in Occupational Dermatology–Current Status and Perspectives;Elsner;JDDG J. Dtsch. Dermatol. Ges.,2018

2. Teledermatology in the Times of COVID-19–A Systematic Review;Elsner;JDDG J. Dtsch. Dermatol. Ges.,2020

3. Dermatology in telemedicine. Possibilities and limits;Elsner;Hautarzt,2002

4. Impact of Standardized Templates and Skin Cancer Learning Modules for Teledermatology Consultations;Cumsky;Int. J. Dermatol.,2019

5. Cutaneous Squamous Cell Carcinoma: A Review of High-Risk and Metastatic Disease;Burton;Am. J. Clin. Dermatol.,2016

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