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Piccolo D, Soyer HP, Burgdorf W, et al. Concordance Between Telepathologic Diagnosis and Conventional Histopathologic Diagnosis: A Multiobserver Store-and-Forward Study on 20 Skin Specimens. Arch Dermatol. 2002;138(1):53–58. doi:10.1001/archderm.138.1.53
To study the validity and feasibility of transferring images of cutaneous
biopsy specimens via e-mail to remote physicians active in dermatopathology
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.
Dermatopathology and pathology units within institutional and private
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.
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.
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.
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