Key skin cancer detection tools in teledermatology

Since 2020, telemedicine has slowly but steadily become mainstream. While general practitioners conduct most telehealth consultations, other specialists are shifting their practice online as well, making their services more accessible to a wider audience. The best example of this trend is telemedicine for dermatology. 

According to Eagle Telemedicine’s 2023 survey, dermatology is the most sought-after type of specialized remote medical care, with the top reasons for consultations being acne, dermatitis, psoriasis, hair loss, and skin cancer. However, only one of the above-mentioned conditions is deadly and therefore requires utmost attention during diagnosis and treatment. Not so long ago, patients worrying about skin oncology had to see a dermatologist in person because online methods were too unreliable. But recently, detection methods have become much more sophisticated, providing an opportunity for patients to be assessed for cancer remotely.

Video calls and store-and-forward apps

For some medical specialties, visual examination of patients is more crucial than others. This is exactly the case for teledermatology, where doctors rely heavily on images and videos taken by patients. Clinicians inspect skin regions that concern patients during the virtual visit, but they also require additional images of these regions from different angles and with varied levels of detail from the patients themselves. 

That’s where applications or portals for storing and transferring high-quality photos and videos come into play. Patients can use their smartphones or digital cameras to take pictures and videos of their skin and then upload them into the teledermatology application. Therefore, teledermatology apps usually have guidelines on the proper way of shooting photos or videos for the remote teledermatology evaluation, as well as quality control systems that reject any images of insufficient quality when a patient tries to upload them.

Photos have to be high-resolution, taken with the flash on and with a short telephoto optical zoom setting to avoid distortions. Overall, these image quality standards are easily met by most modern smartphones and cameras. 

Additional gadgets

While the most important part of the image assessment is dermatology specialists studying the images or videos, multiple supplementary tools help them detect abnormalities invisible to the naked eye.

Dermoscopy is a technique that uses a specialized magnifying device – a dermoscope – to examine skin lesions in greater detail. Many teledermatology providers give patients an option to borrow the device via mail for a couple of weeks to capture dermoscopic images of concerning skin regions. A dermoscope is usually placed on top of the smartphone to align perfectly with the phone camera. Depending on the particular device and providers’ service offer, patients either take photographs as usual or use a supplementary app that enhances the pictures taken with the dermoscope even more.

Epiluminescence microscopy (ELM) is a non-invasive technique that uses polarized light to examine skin lesions from different angles. The ELM device is used in remote dermatology less than the dermascope, and only a few dermatology platforms provide it to patients due to its greater cost. However, EML delivers a three-dimensional view of a skin abnormality, making it easier for dermatologists to identify subtle indicators of possible skin cancer.

Computer-aided diagnosis (CAD) systems use artificial intelligence algorithms to analyze the images and videos of the skin. These systems help dermatologists notice skin abnormalities and deliver a preliminary assessment of the likelihood of skin cancer. According to recent research, doctors who use AI diagnose cancer at early stages more often than those who don’t.

Patient health information management systems

Clinicians need a 360-degree view of patient health to provide accurate diagnosis. This is why in addition to exploring images and examining patients during the video visit, dermatologists use clinical information systems to study additional details about patients’ health and get the full picture of their state. Patient health information management systems like EHR and LIMS are an integral part of telemedicine. They are usually integrated with the telehealth platform to seamlessly give clinicians necessary insights into patients’ health. 

Electronic health records (EHRs) include logs of symptoms that patients have experienced over the years, as well as information about their lifestyle. These insights can give clinicians a clue about the possibility of cancer onset. For example, patients who spend many hours a day in the sun without using sufficient SPF coverage have a higher risk of skin cancer and need to undergo screening more often. EHRs also contain patients’ family history which is essential for predicting the risk of cancer development.

Dermatology patients are often prescribed complete blood cell count, C-reactive protein, liver function, and genetic assessment tests. Since for oncological cases time is essential, clinicians need to receive data from laboratories as quickly as possible. This is where laboratory information systems can help by synchronizing test results with patient records and allowing dermatologists to receive results quickly. 

In conclusion

Teledermatology is a promising medical field that makes early skin cancer diagnosis and better treatment possible. While the current state of this medical field already shows good results in cancer detection and management, further improvement of cameras and connectivity speed as well as the development of more complex and sophisticated computer-aided diagnostics opens up even more exciting opportunities.