A recent study indicates that taking pictures of concerning skin growths and sending them for off-site evaluation is just as effective at diagnosing skin cancers as an in-person examination by a dermatologist.
The researchers highlight that these findings support the idea that this technology can effectively help address diagnostic and treatment gaps for lower-income individuals who may struggle to access dermatological care. Additionally, it could aid dermatologists in swiftly identifying serious cases of melanoma, a type of skin cancer responsible for over 8,000 deaths annually in the U.S.
The innovative system, named SpotCheck, allows skin cancer specialists to examine lesions remotely using dermoscopy, a method where experts utilize a camera paired with a magnifying lens to look below the skin’s surface.
While earlier studies have looked into using telemedicine to expedite melanoma diagnoses and compared remote assessments with in-office evaluations of dermoscopy images, this research is among the first to focus on skin growths that patients noticed first, not just those referred by primary care doctors. This is significant since most melanoma cases are initially detected by patients or their loved ones.
Conducted by a team from NYU Langone Health and its Perlmutter Cancer Center, the analysis involved SpotCheck to assess dermoscopic images of 375 skin lesions from volunteers who were worried that their skin markings might be cancerous. The results, published online on November 9 in the Journal of the American Academy of Dermatology, showed that experts reviewing the images remotely achieved a diagnostic accuracy of 91%, compared to a 93% accuracy rate when dermatologists conducted in-person evaluations.
“Our results suggest that teledermoscopy could not only help healthcare providers detect potentially life-threatening skin cancers earlier but also reduce costly and distressing referrals to specialists for benign conditions,” remarked study senior author David Polsky, MD, PhD.
As reported by the Centers for Disease Control and Prevention, melanoma is the most prevalent cancer in the United States and is notably challenging to treat once it has spread. Previous research indicates that this disease frequently goes undiagnosed among residents of lower-income neighborhoods, who may face obstacles in accessing dermatologists or may have difficulties finding time to attend appointments.
For this study, the research team surveyed 147 participants who responded to newspaper advertisements after noticing suspicious skin lesions. The surveys gathered information about personal and family histories of skin cancer, melanoma risk elements, and the background of each concerning skin lesion. Following this, a general dermatologist examined the lesions visually and through a dermatoscope to make a diagnosis, and biopsies were performed when necessary.
The study coordinator took both clinical and dermoscopic images of the lesions, which were then sent to a central server for review by a team of specialist dermatologists who had expertise with dermoscopy. These dermatologists assessed the questionnaires and images independently, unaware of the preceding in-person evaluations. Additionally, a follow-up phone survey was conducted a week after the volunteers’ appointments to gauge their satisfaction with the process.
The findings revealed that 97% of the assessed lesions were eventually identified as benign through biopsy. Both the dermatologists who conducted in-person evaluations and those who relied solely on images effectively identified 11 out of 13 skin cancer cases, including two melanomas.
Moreover, nearly 90% of patients expressed satisfaction with their telemedicine interactions, with one in five preferring this method over traditional in-person specialist visits.
“One significant advantage of teledermoscopy systems is that community health workers can be taught to gather images and send them for expert review,” stated Polsky, the Alfred W. Kopf, MD, Professor of Dermatologic Oncology at NYU Grossman School of Medicine. “This capability could allow for virtual triage services in clinics, pharmacies, and community health centers in the future.”
Polsky, who also serves as a professor in the Pathology Department at NYU Grossman School of Medicine, mentioned that the research team intends to target neighborhoods with high rates of late-stage melanoma for potential SpotCheck implementation next.
He noted that this tool is designed for assessing specific skin issues and shouldn’t replace comprehensive full-body examinations that a doctor’s office provides; participants had to limit their concerns to three lesions.
The study received funding from the Melanoma Research Alliance, the Sergei S. Zlinkoff Fund for Medical Research and Education, and the Orbuch Brand Pilot Program for Skin Diseases.
Besides Polsky, other investigators from NYU Langone who contributed to this research include Shirin Bajaj, MD; Avani Kolla, MD; Vivienne Li, BA; Payal Shah, MD; Nicholas Gulati, MD, PhD; Maressa Criscito, MD; Yiping Xing, MD; Adriana Lopez, MD; Duy Tran, MD; Vignesh Ramachandran, MD; Efe Kakpovbia, MD; Shane Meehan, MD; Yongzhao Shao, PhD; Kristen Lo Sicco, MD; Emily Milam, MD; Amy Bieber, MD; Amanda Levine, MD; Tracey Liebman, MD; and Jennifer Stein, MD, PhD. Study lead author Jenne Ingrassia, BA, is now a resident physician at New York Medical College in Valhalla.
