greater) with a included). 15-inch or larger colour VGA monitors for evaluating the images. This permitted full screen displays of colour with 480 X 640-pixel resolution. Braun To evaluate the FTF in 6 private Pigmented The diagnostic Picture Not a part of We have identified feasibility and the performed person microscopy practice skin lesions quality was the study the feasibility of a et al. accuracy of the benefit of by the diagnosis (ELM) is a diagnosis evaluated to consultation teledermatoscopic Clinical history teledermatoscopy noninvasive accuracy be good or in approach for benign was not made by in diagnosis of physician trained in was 75% very good in Switzerland: technique for lesions available to teledermatoscopy pigmented skin experienced in DELM (41/55) vs 90% of the a the diagnosis of was superior to the but consider our lesions DELM 64% of FTF DELM pigmented skin conventional study as preliminary (35/55) pictures and as a form of lesions (PSLs). evaluation. J diagnosis (68% vs exploratory for any telemedicine commercially in 95% of the Am Acad 53%). For the other extrapolation, under routine available as macroscopic Dermatol malignant because it conditions in pictures. “dermanet” melanocytic lesions lacks many private practice. system (Arpage it was 100% appropriate controls AG, Zürich, Switzerland compared with 78% 9 benign in this respect. Switzerland) for the conventional lesions were Because clinical Digital approach The information such as diagnostic by a age, sex, risk accuracy for suspect factors for microscopy melanocytic skin melanoma, and assessment (DELM) uses lesions for both phototype was only vs 13 in FTF digital or approaches was available assessment; digitized 67%. in 15% of all cases, no malignant we are unable to lesions were pictures of comment Cohen’s κ. For the PSLs. The on the impact of this agreement of FTF by a system is on our study. diagnosis, we based on a obtained a K value Experience in the commercially of 0.565 field
greater) with a 15-inch or larger colour VGA monitors for evaluating the images. This permitted full screen displays of colour with 480 X 640-pixel resolution. included). Braun et al. in Switzerland: a preliminary evaluation. J Am Acad Dermatol Switzerland To evaluate the feasibility and the benefit of teledermatoscopy in diagnosis of pigmented skin lesions as a form of telemedicine under routine conditions in private practice. performed by the physician experienced in FTF in person DELM diagnosis microscopy (ELM) is a noninvasive technique for the diagnosis of pigmented skin lesions (PSLs). commercially available as “dermanet” system (Arpage AG, Zürich, Switzerland) Digital microscopy (DELM) uses digital or digitized pictures of PSLs. The system is based on a commercially 6 private practice trained in DELM Pigmented skin lesions The diagnostic accuracy of the teledermatoscopic approach for benign lesions was superior to the conventional diagnosis (68% vs 53%). For the malignant melanocytic lesions it was 100% compared with 78% for the conventional approach The diagnostic accuracy for suspect melanocytic skin lesions for both approaches was 67%. Cohen’s κ. For the agreement of FTF diagnosis, we obtained a K value of 0.565 diagnosis accuracy was 75% (41/55) vs 64% of FTF (35/55) Picture quality was evaluated to be good or very good in 90% of the DELM pictures and in 95% of the macroscopic pictures. 9 benign lesions were by a assessment vs 13 in FTF assessment; no malignant lesions were by a Not a part of the study Clinical history was not made available to We have identified the feasibility of a consultation by teledermatoscopy but consider our study as exploratory for any other extrapolation, because it lacks many appropriate controls in this respect. Because clinical information such as age, sex, risk factors for melanoma, and phototype was only available in 15% of all cases, we are unable to comment on the impact of this on our study. Experience in the field
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