Tele-aesthetics in South Asia.

Abstract

Telemedicine is becoming increasingly popular. The best use for it is in the field of aesthetic dermatology - where conditions are not life-threatening, and treatments can be topical and very safe. In this study, we demonstrate that a simple store-and-forward telemedicine system can be applied safely to the field of aesthetic dermatology. This was a prospective study was carried out in Singapore. A total of 102 patients filled up a medical questionnaire and submitted photographs via our online system. Upon submission, there was an independent doctor on the back-end who would review their medical details and their photographs and make diagnoses and recommendations based on this information. There was another doctor who examined the patients face-to-face. Diagnoses made by the online doctor and by the face-to-face doctor were compared for congruency. A total of 358 diagnoses were made by the face-to-face doctor from 102 patients; 346 diagnoses were made by the teleconsultation doctor. For the purpose of this study, the diagnoses made by the FTFD were presumed to be correct. There was total agreement between both doctors in 342 diagnoses, giving a concordance rate of 95.5%. There were 12 missed diagnoses by the teleconsultation doctor and four discordant diagnoses. Our system demonstrates that a store-and-forward system enables our doctor to make accurate skin diagnoses. Our system was also able to detect dangerous conditions such as melanomas, skin cancers, actinic keratosis, and other dangerous diagnoses. There were discordant or missed diagnoses. This was mostly attributed to poor photograph quality. Emerging telemedicine technologies should be rigorously evaluated before they become widely implemented. Any system of value must uphold certain principles. It has to be fundamentally sound, safe, and clearly beneficial to the patient. With current technological limitations, the best use of such a system would be in aesthetics.