teledermoscopy

Teledermoscopy is a subspecialty of telemedicine that enables remote assessment of skin lesions by capturing dermoscopic images and transmitting them to dermatologists or trained clinicians for evaluation.

Images can be obtained using conventional handheld dermatoscopes or smartphone-based dermoscopy adapters. Dermoscopy can use non-contact or contact illumination, with polarized or non-polarized light, and sometimes a contact medium. Images are transmitted via secure telemedicine platforms in store-and-forward fashion or via real-time interactive consultation.

Applications include triage and remote diagnosis of pigmented lesions, monitoring known lesions for changes, and providing second opinions, particularly in primary care, rural or underserved settings, and during public health emergencies.

Advantages include faster access to specialist assessment, reduced patient travel, potential earlier detection of malignant lesions, and educational value. Limitations include image quality dependence, need for proper technique and training, lack of tactile information, not a substitute for biopsy when indicated, and concerns about privacy and data security and regulatory compliance.

Evidence varies; some studies report high concordance with in-person dermoscopy and management changes, while others note limitations due to artifacts, lighting, magnification, and lesion complexity.

History: Teledermoscopy developed with teledermatology, with smartphone-based systems gaining prominence in the 2010s, and continues to evolve with artificial intelligence integration.