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[手机皮肤镜检查:对皮肤病变诊断有可靠帮助吗?]

[Teledermoscopy by mobile phones : Reliable help in the diagnosis of skin lesions?].

作者信息

Zink A, Kolbinger A, Leibl M, Léon Suarez I, Gloning J, Merkel C, Winkler J, Biedermann T, Ring J, Eberlein B

机构信息

Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Klinikum rechts der Isar, Technische Universität München, Biedersteiner Str. 29, 80802, München, Deutschland.

Christine Kühne Center for Allergy Research and Education (CK-CARE), Davos, Schweiz.

出版信息

Hautarzt. 2017 Nov;68(11):890-895. doi: 10.1007/s00105-017-4042-0.

Abstract

BACKGROUND

Teledermoscopy is a promising modern technique to complement or to substitute dermatologic examination.

OBJECTIVE

In this pilot study, we compared the outcomes of teledermoscopic consultations with clinical examinations and histologic results.

METHODS

Conventional and dermatoscopic photos of single lesions were taken in 26 patients using a mobile phone and an attached handyscope optical system. Five resident physicians performed a clinical examination including dermoscopy while the teledermatologic and teledermoscopic photos were assessed by an experienced dermatologist. Examination results were compared regarding diagnosis, differential diagnoses, recommended further management, as well as subjective and objective accuracy of diagnosis. In addition, 23% of the lesions were excised and histologically examined.

RESULTS

The most frequent diagnosis was "nevus cell nevus", followed by "subungual hematoma" and "basal cell carcinoma". The concordance of diagnoses was 92.3%; the concordance of recommended further management was 76.9%. Of the 6 histologically proven diagnoses, 66.7% were given the same diagnosis by teledermatoscopy and conventional clinical assessment. Concerning accuracy of diagnosis, teledermoscopy showed no disadvantage.

CONCLUSIONS

Teledermatologic photos of single lesions combined with teledermatoscopic photos can be reliably and safely assessed. Especially when access to dermatologic examination is difficult, mobile teledermoscopy is a good and reliable alternative.

摘要

背景

皮肤镜检查是一种很有前景的现代技术,可用于补充或替代皮肤科检查。

目的

在这项初步研究中,我们比较了皮肤镜会诊与临床检查及组织学结果。

方法

使用手机和附带的手持皮肤镜光学系统,为26例患者拍摄单个皮损的传统照片和皮肤镜照片。5名住院医师进行包括皮肤镜检查在内的临床检查,而远程皮肤科医生和皮肤镜照片由一位经验丰富的皮肤科医生评估。比较检查结果在诊断、鉴别诊断、推荐的进一步处理以及诊断的主观和客观准确性方面的情况。此外,对23%的皮损进行切除并进行组织学检查。

结果

最常见的诊断是“痣细胞痣”,其次是“甲下血肿”和“基底细胞癌”。诊断的一致性为92.3%;推荐的进一步处理的一致性为76.9%。在6例经组织学证实的诊断中,皮肤镜检查和传统临床评估给出相同诊断的占66.7%。关于诊断准确性,皮肤镜检查没有劣势。

结论

单个皮损的远程皮肤科照片结合皮肤镜照片可以得到可靠且安全的评估。特别是在难以进行皮肤科检查的情况下,移动皮肤镜检查是一种良好且可靠的替代方法。

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