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非典型色素性皮损的远程皮肤镜检查与面对面检查分析:一项横断面回顾性研究。

Analysis of Teledermoscopy and Face-to-Face Examination of Atypical Pigmented Lesions: a Cross-Sectional, Retrospective Study.

作者信息

Fazil Jaber Nor, Jerkovic Gulin Sandra, Seifert Oliver

机构信息

Department of Dermatology and Venereology, Ryhov County Hospital, Jönköping, Sweden.

Division of Cell Biology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.

出版信息

Dermatol Pract Concept. 2023 Jul 1;13(3):e2023212. doi: 10.5826/dpc.1303a212.

Abstract

INTRODUCTION

Malignant melanoma (MM) is one of the most fatal skin cancers. Early detection and treatment are crucial for metastasis prevention. The growing number of MM cases has led to an increased need for skin examinations, increasing the healthcare demand in dermatology departments.

OBJECTIVES

The purpose of this cross-sectional, retrospective study was to analyze the accuracy and reliability of two different methods, teledermoscopy (TD) and face-to-face examination (FTF), with two different patient groups for MM detection in Jönköping County.

METHODS

In teledermoscopic evaluation, a general practitioner takes photographs of a suspected skin lesion (clinical and dermoscopic images) and sends TD referrals to a dermatologist for digital assessment. In the FTF group, the diagnosis was made during regular clinical visits to the dermatology department by a dermatologist.

RESULTS

The TD group comprised 55 women and 57 men, and an FTF group comprised 72 women and 66 men. Based on the histopathology report, in the TD group, 75% of suspected MM lesions were accurately classified as MM compared with 57% of suspected MM lesions correctly diagnosed in the FTF group. When compared with histopathology report, the diagnostic concordance of TD and FTF examinations were 80% and 69%, respectively.

CONCLUSIONS

We report a high diagnostic concordance between TD and the final histopathological diagnosis. Metrics analyzed for diagnostic accuracy confirmed that TD is an effective and accurate method for early diagnosis of MM. TD is suitable, non-inferior and a useful alternative to FTF examination.

摘要

引言

恶性黑色素瘤(MM)是最致命的皮肤癌之一。早期发现和治疗对于预防转移至关重要。MM病例数量的不断增加导致皮肤检查需求增加,从而增加了皮肤科的医疗需求。

目的

本横断面回顾性研究的目的是分析两种不同方法,即远程皮肤镜检查(TD)和面对面检查(FTF),在延雪平郡对两组不同患者进行MM检测的准确性和可靠性。

方法

在远程皮肤镜评估中,全科医生拍摄疑似皮肤病变的照片(临床和皮肤镜图像),并将TD转诊提交给皮肤科医生进行数字评估。在FTF组中,由皮肤科医生在定期前往皮肤科就诊时进行诊断。

结果

TD组包括55名女性和57名男性,FTF组包括72名女性和66名男性。根据组织病理学报告,在TD组中,75%的疑似MM病变被准确分类为MM,而FTF组中正确诊断的疑似MM病变为57%。与组织病理学报告相比,TD和FTF检查的诊断一致性分别为80%和69%。

结论

我们报告了TD与最终组织病理学诊断之间的高诊断一致性。对诊断准确性进行分析的指标证实,TD是早期诊断MM的有效且准确的方法。TD是合适的、非劣效的,并且是FTF检查的有用替代方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1216/10412092/3c663a3e2a2c/dp1303a212g001.jpg

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