JMIR Publications

ABSTRACT

Background:

The role of teledermatology for skin lesion assessment has been a recent development, particularly since the COVID-19 pandemic has impacted the ability to assess patients in person. The growing number of studies relating to this area reflects the evolving interest.

Objective:

The objective of this literature review is to analyse the available research on store-and-forward teledermatology for skin lesion assessment.

Methods:

MEDLINE was searched for articles from 2010 up to November 2021. Articles were searched for relevance to the following areas: time management, effectiveness, reception amongst patients and healthcare professionals, image quality, equity of services, education potential, fiscal measures, and medicolegal issues.

Results:

The reported effectiveness of store-and-forward teledermatology for skin lesion assessment produces heterogeneous results, likely due to large variations in procedures. Most studies show high accuracy and diagnostic concordance of teledermatology compared to in-person dermatologist assessment and histopathology. This is improved through the use of teledermoscopy. Most literature shows improvement in time to advice and definitive treatment when utilising teledermatology. The main limitation relates to incidental skin lesions which are not able to be assessed by teledermatology.

Conclusions:

Overall teledermatology offers a comparable standard of effectiveness to in-person assessment. It can save significant time in expediting advice and management. The significant number of incidental skin lesions in high-risk groups means it cannot completely substitute for an in-person assessment. The wide variation in the structure of local health systems and funding between countries and even within them means that the generalisability of teledermatology pathways described in research is difficult to predict.