Introduction: Speculatively, digital image post-processing (DIPP) enhances diagnostic accuracy in dermoscopy.

Objective: We aimed to investigate the advantages and limitations of DIPP, as well as its perceived reliability and safety.

Methods: In this study we investigated perception and use of DIPP among members of the International Dermoscopy Society through a web-based survey with 17 questions focusing on: (I) demographics (sex, age, nationality, specialty, professional experience in dermoscopy), (II) application of digital dermoscopy, (III) imaging devices, (IV) DIPP software usage, (V) area of DIPP application (e.g., neoplastic dermatoses or inflammoscopy), preference over manual or automatized DIPP, (VI) personally adjusted parameters, (VII) perceived reliability and safety of DIPP, and (VIII) an open comment section.

Results: A total of 360 respondents (64 countries) completed the survey. While 91.7% of respondents reported capturing dermoscopic images during examination, only 22.4% of them declared using DIPP. We have demonstrated that DIPP was used more commonly with smartphones, rather than video dermatoscopes or digital cameras and for dermoscopy of neoplastic dermatoses rather than inflammoscopy. Respondents tended to adjust image parameters manually. The perceptions of its usefulness and safety were good, even though slight variability across geographic regions was observed.

Conclusion: Given that no regulations for DIPP exist, healthcare professionals involved with dermoscopic image acquisition and archiving may require special training to responsibly implement DIPP in their practices.

To read the full article please click here.

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Key Points

Question  Does the use of 3-dimensional (3D) total-body photography improve early detection of melanoma and other skin cancers in individuals at high risk of melanoma?

Findings  This randomized clinical trial including 314 patients at high risk of melanoma found that adding 3D total-body photography and sequential digital dermoscopy (via telehealth) to usual clinical surveillance increased the overall number of excisions. However, it did not change the average number of melanomas detected per person in the intervention group compared with the control group.

Meaning  These findings indicate that careful implementation is required to offset increased biopsies of benign lesions in patients at high risk, and further trials are needed in which 3D total-body photography is integrated with teledermatology services or compared with usual care instead of being offered as an add-on service.

To read the abstract please click here.

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The way this is achieved is by imaging and mapping of the body, any changes in the skin can then be easily monitored using applicable software. A follow up visit from a patient would then become as simple as comparing the previous digital image to the current one by using the applicable software. Continuing on from this, any future appointments would be able to observe clear trends over multiple images. These images and comments are kept in chronological order allowing for future easy observation of patient history and clear monitoring of any changes to the skin. Importantly images may also be displayed over one another to allow for easy recognition of changes in skin lesions.

Not only are follow-ups and digital skin imaging made easy with the right software, but this process means that any unnecessary painful skin incisions are avoided. As well as this obvious improvement to patient care the types of data captured and the overall patient care that is employed by software also conclusively supports patient care. Data around patient details, lesion clinical observations, location, provisional diagnosis, suggested management, procedure date, histopathology report, final diagnosis, comments and next appointment date are easily recorded.

This type of automated process allows for a completely improved workflow, to the addition of dramatically improving time management as well.

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