Remote videodermoscopy provides reliable diagnosis of skin cancer

A new study shows that capturing images of suspicious skin lesions and sending them to specialists for review is as accurate in detecting skin cancer as an in-person examination by a dermatologist.

According to the study authors, the findings confirm that such technology can help address disparities in diagnosis and treatment for low-income populations with limited access to dermatologists. It could also help dermatologists quickly identify cases of melanoma, a serious form of skin cancer.

The new system, which the researchers have named SpotCheck, allows dermato-oncologists to remotely examine skin lesions using the well-known technique of dermoscopy, in which specialists use a camera connected to a special magnifying lens to look more deeply into the skin.

Although previous studies have examined the potential of telemedicine to speed melanoma diagnosis and compared in-person and remote evaluation of dermoscopy images, the authors say their work is one of the first to focus on skin neoplasms identified by concerned patients rather than primary care physicians.

In the new analysis, conducted by a team from NYU Langone Health and the Perlmutter Cancer Center, SpotCheck was used to evaluate dermoscopic images of 375 skin lesions obtained from volunteers who were concerned that their skin neoplasms might be malignant.

According to the results, published in the Journal of the American Academy of Dermatology, dermoscopy experts who remotely viewed all samples made a diagnosis with 91% accuracy (biopsies were subsequently taken to compare results). The accuracy of dermatologists who performed the examination in person at the outpatient clinic was 93%.

The results of this study suggest that remote dermoscopy may not only help health care providers detect potentially dangerous skin cancers at an early stage, but also reduce the number of costly referrals to specialists for benign growths.

For the study, the team administered questionnaires to 147 men and women who responded to advertisements after discovering suspicious growths on their skin. The questionnaires assessed personal and family history of skin cancer, risk factors for melanoma, and the history of each suspicious spot on the skin. A dermatologist then performed a visual inspection of the neoplasms and a dermatoscope examination, and if necessary, ordered a biopsy.

The study coordinator obtained clinical and dermoscopic images, which were sent to a central server for remote review by a separate team of skin cancer specialists with expertise in dermoscopy. They reviewed the questionnaires and images and made their own diagnosis. This group of dermatologists was not familiar with the results of the face-to-face evaluation.

The results of the study showed that overall 97% of the lesions examined were found to be benign, which was confirmed by subsequent biopsy. Notably, both dermatologists who examined participants in person and those who relied only on clinical photographs and dermoscopy identified 11 of the 13 skin cancers, including two melanomas.

The results also showed that nearly 90% of patients were satisfied with telemedicine, and 20% reported that they preferred this method of examination to seeing a specialist in person.