Pilot Teledermatology Service for Assessing Solitary Skin Lesions in a Tertiary London Dermatology Center.

BACKGROUND: Efficient clinical pathways are needed to meet the growing pressures in dermatology due to the significant rise in the number of suspected skin cancer referrals. Our hospital serves a wide geographical area and receives a large number of 2-week-wait (2WW) suspected skin cancer referrals. In the United Kingdom, approximately 10-12% of 2WW referrals are diagnosed as skin cancers fulfilling the 2WW criteria.

PURPOSE: We sought to assess the role of teledermatology in reducing hospital consultations for patients referred via the dermatology 2WW pathway.

METHODS: We piloted a teledermatology service and detailed the clinical outcomes of patients with solitary skin lesions of uncertain diagnosis triaged through this pathway. Seventy-six primary care referrals were reviewed by consultant dermatologists and analyzed against the British Association of Dermatologists' teledermatology audit standards.

RESULTS: In 52/76 (68%) of patients, confident benign diagnoses were made, avoiding the need for a face-to-face (FTF) consultation.

CONCLUSIONS: Our results showed that with adequate image quality, teledermatology can be used to accurately diagnose skin lesions.

IMPLICATIONS: Teledermatology can significantly reduce the number of urgent referrals necessitating FTF appointments, therefore providing a new solution to streamline care delivery.