General Practitioners Use Digital Cameras and Internet for Telepathology of Skin Lesions

Abstract

This paper describes a pilot study in Dutch teledermopathology. Three general practitioners (GPs) were provided with a digital camera by their pathologist at the Leiden Cytology and Pathology Laboratory (LCPL). Following a protocol, they documented the skin lesions of 122 patients before taking biopsies. The digital images were sent by e-mail to the LCPL. The biopsies were sent by conventional mail to the LCPL, and handled according to routine procedures. All images proved informative for the pathologist. The GPs prediction/expectation of malignancy was compared with the outcome of histology. Nonconcurring diagnoses were analyzed. Among the most common diagnoses, the benign lesion verruca proved difficult for the GPs, whereas basal cell carcinoma proved relatively easy. The documentation of the clinical presentation of skin lesions proved simple and highly successful. In case of referral to hospitals and treatment by specialists comprehensive electronic reports were available and helpful in patient management. The omnipresence of the internet plays an important role in this project. The pilot study revealed positive added value of the digitized images.