The Role of Teledermatology and Teledermoscopy in the Diagnosis of Actinic Keratosis and Field Cancerization.

The Journal of Investigative Dermatology
Joaquin Sola-OrtigosaGrup d'Estudi de Teledermatologia del Vallès Oriental

Abstract

Actinic keratosis (AK) and field cancerization are increasing health problems insufficiently diagnosed by primary care physicians. The objective of this study was to assess the validity and reliability of teledermatology (TD) and teledermoscopy in the diagnosis of AK and field cancerization in a gatekeeper healthcare model. A prospective diagnostic test evaluation was done to assess the diagnostic concordance, accuracy, and performance parameters and the interobserver and intraobserver concordances of TD and teledermoscopy compared with dermatologists' face-to-face evaluation or histopathology. A total of 636 patients with 1,000 keratotic skin lesions were included. TD diagnostic concordance for AK and field cancerization evaluation was very high and superior to primary care physicians' diagnosis (92.4% vs. 62.4% and 96.7% vs. 51.8%, P < 0.001). TD sensitivity, specificity, and positive and negative predictive values for AK diagnosis and field cancerization were high (range = 82.2-95.0) and better than primary care physicians' diagnosis. Teledermoscopy yielded better results in diagnostic concordance, performance parameters, and AK subtypes. Intraobserver and interobserver agreement was >0.83. TD and, to a greater extent, teled...Continue Reading

Citations

Jul 30, 2020·Archives of Dermatological Research·Edward HadelerKeyvan Nouri
Jan 17, 2021·The Journal of Investigative Dermatology·Joaquin Sola-OrtigosaUNKNOWN Grup d’Estudi de Teledermatologia del Vallès Oriental
May 8, 2021·Italian Journal of Dermatology and Venereology·Linda TognettiPietro Rubegni
Sep 24, 2021·Journal of Cutaneous Medicine and Surgery·Farhan MahmoodCarly Kirshen

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