Evaluation of Diagnostic Accuracy and Therapeutic Approach of Dermatologists and Plastic Surgeons To Non-Melanocytic Skin Lesions By Using Telemedicine

Introduction: In the new circumstances of coronavirus disease 2019 pandemic, tele-dermatology and tele-dermoscopy have become more important in daily practice for departments for which visuality is at the forefront as dermatology and plastic and reconstructive surgery. Objectives: This study was aimed to determine diagnostic accuracy and treatment approaches of non-melanocytic skin lesions between 2 clinics by store and forward tele-dermatology method and to evaluate the contribution of tele-dermoscopy to the diagnostic accuracy for dermatologists. Methods: A total of 26 patients with non-melanocytic skin lesions were included in the study. Clinical images of the lesions were sent by email to 3 plastic surgeons and 3 dermatologists. The accuracy of the diagnoses was evaluated by comparing tele-dermatology with histopathology. Diagnosis and treatment approaches were recorded for both clinics. Dermatologists also defined their diagnosis with tele-dermoscopic images. Results: The mean percentage of diagnostic accuracy among dermatologists was 74.3% and among plastic surgeons was 61.5%. There was no significant difference in diagnostic accuracy between departments (P = 0.625). There was a statistically significant difference between the departments for diagnostic and treatment approaches (P values respectively P = 0.002, P < 0.001). Plastic surgeons preferred to confirm their pre-diagnosis histopathologically more than dermatologists. Plastic surgeons recommended surgical procedures for 25 lesions (96.2%) while dermatologists for 14 (53.8%) ones. Tele-dermoscopy increased the rate of diagnostic accuracy of dermatologists from 74.3% to 82.0% (P = 0.02). Conclusions: Tele-dermatology is an effective method for non-melanocytic skin lesions with high diagnostic accuracy. Adding dermoscopy to tele-dermatology increases diagnostic accuracy of dermatologists on non-melanocytic skin lesions.