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.