32746 The clinical utility of teledermatology in triaging and diagnosing skin malignancies: A series of three cases

Abstract

Teledermatology is a rapidly growing digital resource within the field of dermatology with specific utility in triaging patients to determine those requiring in-person evaluation for early and accurate detection of skin malignancies. Previous studies have demonstrated that approximately one-third of teledermatology consultations result in face-to-face clinical encounters with malignant neoplasms being the leading cause for biopsy. For specific populations, such as geriatric, immunocompromised, or those with limited access to in-person health care, teledermatology serves as a valuable tool. We describe the clinical utility of teledermatology in triaging and diagnosing skin malignancies through the presentation of 3 cases obtained from digital image review at 1 large, midwest medical center during the month of July 2021. Three unique cases with final diagnoses of a rare or aggressive skin cancer were selected as examples, including a 75-year-old man with Merkel cell carcinoma, a 55-year-old man with aggressive pT3b malignant melanoma, and a 72-year-old man diagnosed with an atypical fibroxanthoma. The visual representation of the clinical timeline of each case is presented, including time intervals from initial image submission to image review, image review to face-to-face clinical encounter, and image review to final diagnosis. These cases serve as important examples of the application of teledermatology in reducing the time to diagnosis of aggressive skin malignancies. Given the current pandemic and the increasing, widespread use of digital technology within the field of dermatology, further demonstration of the clinical utility of teledermatology is warranted and additional research in the area of digital and electronic technology is required.