Truong Kelvin, Elhindi James, Araujo Raquel Ruiz, Jones-Caballero Maria, Chamberlin Charmaine, Wells Jillian, Fernandez-Penas Pablo
Department of Dermatology, Westmead Hospital, Westmead, New South Wales, Australia.
Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Australas J Dermatol. 2025 Sep;66(6):344-349. doi: 10.1111/ajd.14531. Epub 2025 May 23.
Mycosis fungoides (MF) requires accurate clinical assessment for staging and management. Teledermatology aids remote evaluations, but there is limited data on the use of 3D total body photography (TBP) in assessing MF.
This study evaluates the accuracy and reliability of assessing a patient with MF using 3D TBP compared to in-person review.
Thirteen MF patients were evaluated in-person using the modified Severity Weighted Assessment Tool (mSWAT) by two dermatologists, and then had 3D TBP taken. 8 weeks later, the dermatologists evaluated the virtual images. Three independent dermatologists reviewed the virtual images twice, 8 weeks apart. Intraclass correlation coefficients (ICC) assessed agreement between in-person and virtual assessments and test-retest reliability.
There was moderate agreement (ICC = 0.71) for intra-rater in-person and virtual assessments. Test-retest reliability of virtual assessment was good (ICC = 0.79). Evaluating inter-rater agreement between in-person and virtual assessments indicated good agreement (ICC = 0.80).
3D TBP could not capture skin on the scalp, beneath clothing and on the soles of the feet, limiting complete assessment.
Clinical assessment of mSWAT using 3D TBP is as reliable as in-person mSWAT, suggesting its potential in teledermatology. Further studies are needed to validate these findings in larger cohorts.
蕈样肉芽肿(MF)的分期和管理需要准确的临床评估。远程皮肤病学有助于进行远程评估,但关于使用三维全身摄影(TBP)评估MF的数据有限。
本研究评估与亲自检查相比,使用三维TBP评估MF患者的准确性和可靠性。
13例MF患者由两名皮肤科医生使用改良的严重程度加权评估工具(mSWAT)进行亲自评估,然后进行三维TBP拍摄。8周后,皮肤科医生评估虚拟图像。三名独立的皮肤科医生对虚拟图像进行两次评估,间隔8周。组内相关系数(ICC)评估亲自评估和虚拟评估之间的一致性以及重测可靠性。
评估者内亲自评估和虚拟评估之间存在中度一致性(ICC = 0.71)。虚拟评估的重测可靠性良好(ICC = 0.79)。评估亲自评估和虚拟评估之间的评估者间一致性显示良好一致性(ICC = 0.80)。
三维TBP无法捕捉头皮、衣服下面和脚底的皮肤,限制了全面评估。
使用三维TBP对mSWAT进行临床评估与亲自进行mSWAT一样可靠,表明其在远程皮肤病学中的潜力。需要进一步研究以在更大的队列中验证这些发现。