Use of the mobile phone multimedia messaging service for teledermatology

We examined the feasibility of using mobile phone Multimedia Messaging Service (MMS) to send teledermatology referrals from a general practitioner to a dermatologist. Digital photographs of skin conditions in 40 consecutive patients were sent together with relevant clinical information to dermatologists at a university hospital. Two dermatologists separately assessed the MMS referrals. The suspected diagnosis, triage and management decisions were compared to those given after separate face-to-face (FTF) visits, and again after agreeing on a final clinical and/or histopathological diagnosis. Thirty-two patients (80%) were diagnosed with skin tumours and 8 patients (20%) with other skin conditions. Both dermatologists were able to make a correct diagnosis in 31 patients (78%) based solely on the MMS referral. They also provided adequate management recommendations for 98% of the patients. Adequate triage decisions after assessment of the MMS referrals were made for 34 (85%) and 38 (95%) patients by the two dermatologists. There was an inter-observer concordance of 68% for the teledermatology diagnosis, compared to 88% concordance after the separate FTF visits. The diagnostic accuracy and adequacy of the triage and management decisions achieved using MMS referrals were similar to those obtained with other store-and-forward teledermatology methods.