Introduction: Improving remote triage is crucial given expansions in tele-dermatology and with limited in-person care during COVID-19. In addition to clinical pictures, dermoscopic images may provide utility for triage.
Objectives: To determine if dermoscopic images enhance confidence, triage accuracy, and triage prioritization for tele-dermatology.
Methods: In this preliminary parallel convergent mixed-methods study, a cohort of dermatologists and residents assessed skin lesions using clinical and dermoscopic images. For each case, participants viewed a clinical image and determined diagnostic category, management, urgency, and decision-making confidence. They subsequently viewed the associated dermoscopy and answered the same questions. A moderated focus group discussion followed to explore perceptions on the role of dermoscopy in tele-dermatology.
Results: Dermoscopy improved recognition of malignancies by 23% and significantly reduced triage urgency measures for non-malignant lesions. Participants endorsed specific utilities of tele-dermoscopy, such as for evaluating pigmented lesions, with limitations including poor image quality.
Conclusions: Dermoscopic images may be useful when remotely triaging skin lesions. Standardized imaging protocols are needed.
Keywords: dermoscopy; melanoma; skin cancer; tele-dermatology; telemedicine.
©2022 Rogers et al.