Transcript Teledermatology - Queen`s University Belfast

Tele-dermatology
A Randomised Controlled Study Using Polaroid Photography to Diagnose Skin Conditions
P.Leggett1,D.Gilliland1,M.Cupples1,K.McGlade1, R.Corbett2, M.Stevenson3,K.Steele1
Dept General Practice Queens University1 Dept Dermatology Belfast City Hospital2 Dept Epidemiology Queens University3
Background: Of all GP consultations, 15% are for dermatological conditions-4% of these
Methodology
require referral to a dermatologist.In this study we assess the value of polaroid photography in
 Randomised controlled trial
helping a dermatologist manage patients referred from GPs. Our objective was to determine
whether a polaroid photograph(s), with a clinical history, enables a final diagnosis & management  136 patients (5months-94 years; 55male,81 female)
 Recruited from 5 urban general practices
plan to be made without the patient having to see the dermatologist face to face.
 Polaroid photograph(s) taken by referring GP
 Standard clinical history sent with photograph(s)
Final
Diagnosis
Eczema
Control
Group
total
numbers
Total
Numbers
14
13
Study Group
PhotoDiagnosis
made/
patient
not seen
PhotoDiagnosis
made/ patient
needed
appointment
PhotoDiagnosis
not
possible
5
5
3/13(23%)
Naevus
9
12
3
7
2/12(17%)
Psoriasis
4
4
2
1
1 /4(25%)
Keratosis/seb.wart
7
6
1
1
4/6(67%)
Bowens/Bcc/Scc
4
4
0
3
1 /4(25%)
Infective Cond.s
4
11
5
0
6/11(55%)
Other
13
11
2
2
7/11(64%)
Patient cancelled
4
2
0
2
1
Patient dna’d
6
5
0
4
1
Total
65
71
18
27 (1ltf)
26(1ltf)
*ltf=lost to follow up
Table summarising the diagnoses in the study and control groups
Outcomes
136 Patients
65 Control
Seen by dermatologist
in the usual way
18
did not need
to be seen
71 Study Cases
45
photo-diagnosis
possible
27
needed to
be seen
26
photo-diagnosis
not possible
Seen in usual
way
Of the 27 photo-diagnosis patients who needed to be seen, 20
attended their out-patient appointment and in 19 (95%) of these the
face-to-face diagnosis was identical to the photo-diagnosis.In one
case the diagnosis was changed from eczema to psoriasis.
Conclusions

Polaroid photographs can be used by dermatologists to
aid the diagnosis of various dermatological conditions

Polaroid photography offers the potential to reduce the
number of attendances at dermatology out-patient clinics

Polaroid photography represents a simple, easy to use
and inexpensive method of relaying relevant information
to a dermatologist