The Diagnostic Accuracy of Skin Diseases Via Teledermatology – A Single Center Study

Background: Teledermatology emerged as a safe tool that could fill healthcare gaps in underprivileged remote areas. Objective: To compare the diagnostic accuracy of teledermatologists with in-clinic dermatologists and assess various methods of photo capturing skin lesions, for better incorporation of teledermatology into clinical practice. Methods A single center randomized prospective trial at the American University of Beirut Medical Center involved adult participants seeking dermatologic consultation. Three sets of photographs were taken: patient-taken without guidance/unassisted, patient-taken with guidance/assisted, and resident-taken. Results: Diagnosis match with in-clinic visits increased from patient-unassisted (79%) to patient-assisted (84%) to resident-taken photographs (87%). Similarly, treatment match increased among the 3 modes respectively (38%,44% and 45%) and need for history decreased among the 3 modes respectively (64%, 59%, and 47%). Acne cases had higher diagnosis matches than malignant tumors and papulosquamous dermatoses among the three modes. Conclusion: A limitation of this study was the reliance on in-clinic expert opinions as “true diagnosis or treatment” for comparison purposes. Teledermatology’s accuracy in diagnosing common dermatoses, coupled with proper patient education on picture taking holds promise in its integration into clinical practice.