A 9-Year Teledermoscopy Service in New Zealand: Retrospective Service Review

Area of Science:

• Dermatology
• Health Informatics
• Telemedicine

Background:

• Established in January 2010, a teledermoscopy service facilitated remote diagnosis of skin lesions through nurse-led imaging clinics.
• This model aimed to improve patient access to dermatological expertise.

Purpose of the Study:

• To analyze patient demographics, service utilization, diagnostic outcomes, and efficiency of the teledermoscopy service.
• To identify risk factors associated with melanoma diagnosis within the service population.

Main Methods:

• Retrospective analysis of patient visits, skin lesion diagnoses, and waiting times from January 2010 to May 2019.
• Statistical analysis of patient characteristics, including sex, ethnicity, age, and Fitzpatrick skin type, in relation to melanoma diagnosis.

Main Results:

• The service managed 11,005 skin lesions across 8805 occasions for 6479 patients.
• Male sex, European ethnicity, age 65-74, and Fitzpatrick skin type 2 were significant risk factors for melanoma.
• Common diagnoses included benign naevus (26.7%), benign keratosis (23.4%), and keratinocytic cancer (15.5%); melanoma was suspected in 4.6% of lesions, with a positive predictive value of 61.1%.

Conclusions:

• Nurse-led teledermoscopy clinics offer an efficient and accessible model for dermatology services.
• The service effectively streamlines referrals and prioritizes skin cancer patients for timely treatment.