Concordance Between Telepathologic Diagnosis and Conventional Histopathologic Diagnosis: A Multiobserver Store-and-Forward Study on 20 Skin Specimens | Dermatology | JAMA Dermatology | JAMA Network
[Skip to Navigation]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
January 2002

Concordance Between Telepathologic Diagnosis and Conventional Histopathologic Diagnosis: A Multiobserver Store-and-Forward Study on 20 Skin Specimens

Author Affiliations

From the Departments of Dermatology of the University of L'Aquila, L'Aquila, Italy (Drs Piccolo and Peris); University of Graz, Graz, Austria (Drs Soyer, Cerroni, and Kerl); General Hospital, Jesi, Italy (Drs Bugatti and Filosa); University of Tor Vergata, Rome, Italy (Dr Chimenti); Philipp University, Marburg, Germany (Dr Hoffmann); BioLab Laboratory for Histopathology, Prague, Czech Republic (Dr Julis); Gemeinschaftspraxis, Friedrichshafen, Germany (Dr Kutzner); University of Bologna, Bologna, Italy (Dr Misciali); General Hospital, Salzburg, Austria (Dr Schaeppi); Keio University, Tokyo, Japan (Dr Tanaka); and University of Innsbruck, Innsbruck, Austria (Dr Zelger); from Tutzing, Germany (Dr Burgdorf); the Departments of Epidemiology (Drs Talamini and Filosa) and Pathology (Dr Canzonieri), Centro di Riferimento Oncologico, Aviano, Italy; and the Departments of Pathology of the University Federico II, Naples, Italy (Dr DeRosa); General Hospital S. Filippo Neri, Rome (Dr Manente); and the Geisinger Medical Center, Danville, Pa (Dr Tyler).

Arch Dermatol. 2002;138(1):53-58. doi:10.1001/archderm.138.1.53

Objective  To study the validity and feasibility of transferring images of cutaneous biopsy specimens via e-mail to remote physicians active in dermatopathology for teleconsultation.

Design  Twenty skin specimens previously diagnosed at the Department of Dermatology, University of Graz, Austria, were subsequently sent for teleconsultation using the store-and-forward method. For each case, 3 or 4 images at different magnifications were sent by e-mail to 16 colleagues (11 dermatopathologists and 5 pathologists) in 15 centers in 6 different countries. Six weeks later each observer received the hematoxylin-eosin–stained specimens to render a conventional diagnosis.

Setting  Dermatopathology and pathology units within institutional and private settings.

Material  Twenty small skin biopsy specimens of cutaneous diseases were selected randomly from a study set of 80.

Main Outcome Measure  Concordance between telepathologic diagnoses and conventional histopathologic diagnoses of 20 skin specimens.

Results  On average, 78% of the telediagnoses were correct (range, 60%-95%), whereas 85% of the conventional diagnoses were correct (range, 60%-95%). A perfect diagnostic concordance was obtained in 7 (35%) of 20 cases, and a significant difference was identified in only 1 case.

Conclusions  Results suggest that telepathology performed by physicians active in dermatopathology may serve as a reliable technique for the diagnosis of cutaneous diseases when experts in dermatopathology are not available locally. Furthermore, teledermatopathology is attractive because it provides an opportunity to obtain timely consultation on difficult cases.