Introduction:
Telemedicine is the practice of using communication technologies to deliver medical advice and assistance. The Greek term "tele" is the source of the English word “telemedicine.” In teledermatology, the patient's photos are transmitted to the teleconsultant as the first step, and the consultant then provides a plan of action for diagnosis or care. Real-time teledermatology incorporates a live video consultation with the patient. The delivery of dermatology treatments could be revolutionized by teledermatology, which also offers equitable service to rural locations and enables primary care physicians to send patients to dermatology centers of excellence remotely. However, a comprehensive evaluation must confirm its dependability, accuracy, and cost-effectiveness before its normal implementation as a service instrument. When digital images or photographs are provided along with clinical history, teledermatology can be used.
What Is Teledermatology?
Teledermatology is the study of dermatology using telemedicine's basic concepts. Teledermatology has traditionally been divided into two categories:
1. Real-Time Teledermatology - Live videoconferencing is used to communicate between patients and providers.
2. Store-And-Forward Teledermatology - Usually, this refers to transferring or forwarding digital photographs and related patient information to the dermatologist for perusing, assessing, and consulting.
One of the early developers of teledermatology protocols that have been modified for use in civilian operations is the US (United States) Department of Defense. Although systematic reviews have stated that more thorough studies are needed to explore the economic aspects of telemedicine, telemedicine is generally thought to be cost-effective.
What Is Mobile Teledermatology?
Mobile-teledermatology is the name given to teledermatology performed utilizing a mobile device. Teledermoscopy, in which medical professionals consult on dermoscopic images transmitted electronically, and teledermatopathology or telecytology, in which dermatopathology or cytology images are transferred, are examples of extensions of teledermatology.
Smartphone teledermatology is the best instrument for patient-initiated teledermatology because of how simple it is to use. The use of smartphones to conduct teledermatology is a development of this approach.
What Are the Advantages of Teledermatology?
A. Cosmetic Medicine - Teledermatology is advantageous in cosmetic medicine because it typically deals with illnesses that are not emergencies or life-threatening. Therefore, Teledermatology can be utilized for the initial diagnosis of aesthetic disorders and follow-up care with aesthetic patients, particularly post-procedure, like keeping track of those who have had laser resurfacing.
B. Malignancies - The somewhat heavy and expensive equipment needed to communicate data was one of the drawbacks of teledermatology in its early years. However, clinical image collection, transmission, and storage quality have improved thanks to technology. Additionally, connecting smartphones to internet networks is simple. It has been discovered that smartphone-based teledermatology and teledermoscopy are useful for diagnosing and prioritizing dermatological diseases, including malignancies.
C. Patient Satisfaction - Studies have demonstrated that teledermatology provides good patient satisfaction and diagnostic concordance compared to in-person consultations.
D. Shortens Referral Times - Even in cases with cutaneous cancers, teledermatology can be a useful triage technique that shortens referral times, especially in conjunction with teledermoscopy. Even though teledermatology is typically associated with outpatient dermatology, studies have demonstrated that it can be a valuable and successful tool in inpatient dermatology.
E. Monitoring Skin Conditions - Teledermatology has been helpful in the monitoring of chronic skin conditions, such as persistent ulcers.
F. Reduces Waiting Time - Patients and primary care physicians both benefit greatly from teledermatology. Teledermatology dramatically reduces waiting times with more predictable patient access and lower patient expenditures in light of the present dermatologist scarcity and limited access to dermatologists in many rural or underprivileged regions, such as for traveling or missing work.
G. Medical Education - Additionally, teledermatology, which is frequently arranged through the patient's primary care doctors, provides more chances for primary care doctors to get a medical education. Additionally, it facilitates the expedited use of diagnostic tests, medicinal treatments, and surgical procedures for more serious, urgent medical issues.
What Is the Requirement for Teledermatology?
Good infrastructure is necessary for effective teledermatology on both sides of the consultation. For example, the infrastructure in rural places could be better, and there are frequently no image capture devices or internet connections, which lowers the quality of clinical data. In addition, all teledermatology practitioners must have a foundational understanding of dermatological nomenclature and imaging.
The idea of teledermatology depends on an appropriate electronic medical record system, including storing linked pictures. Unfortunately, there are considerable regional differences in the use of electronic medical records and their breadth. Therefore, it would be crucial to standardize dermatological imaging and the associated electronic medical records to raise the caliber and efficiency of teledermatology procedures.
What Are Telecytology and Telepathology?
To enhance the diagnostic capacity of teledermatology, telepathology, and telecytology combine clinical data with high-quality, supporting pathology and cytology data. In addition, the growth of robot-assisted microscopy and improvements in the digitization of histopathology slides have made teledermatopathology more practical and efficient.
Can Teledermatology Be Employed for the Detection of Skin Cancer?
Screening for skin cancer has the potential to lower cancer-specific morbidity and mortality. Total-body inspections continue to be the standard idea for skin cancer screening. On the other hand, store and forward teledermatology has proven reliable tools for various diagnostic uses, primarily in specialized dermatological settings. Recent research found that with seven incidences of skin cancer among 195 skin lesions, teledermatology with or without dermoscopic pictures eliminated all skin malignancies (sensitivity and negative predictive value 100 %). Higher specificity (85 % vs. 77 %) was obtained by combining dermoscopic pictures with conventional images, which allowed for the avoidance of needless further testing in a greater percentage of skin lesions.
Conclusion:
Teledermatopathology is the transmission of dermatopathology pictures via a store-and-forward system or in real-time using a robotic microscope (transmission as a single file). Virtual slide systems are a recent invention in the latter method (SAF) (VSS). Over the past two decades, the potential of teledermatology has increased. Dermatology naturally relies on visual communication, which makes it a perfect telemedicine application. The fundamental ideas of teledermatology have been applied successfully in residency programs and dermatological instruction. A cost-efficient way to involve expert academics in teaching programs is through the appropriate use of telemedicine. In addition, participants like dermatologists and primary care physicians can learn from teledermatology independently. Aside from interpreting patch tests, teledermatology has proven useful in other operations.
