Developing and evaluating a mobile-based teledermatology system for skin lesion diagnosis in Iran

Area of Science:

• Dermatology
• Medical Informatics
• Digital Health

Background:

• Asynchronous teledermatology (TD) offers potential to enhance dermatological care access.
• Existing TD studies exhibit diverse methodologies and outcomes.
• There is a need for standardized, accessible TD tools, particularly in regions with limited specialist availability.

Purpose of the Study:

• To design and implement a mobile application for asynchronous teledermatology in Iran.
• To utilize the store-and-forward model for collecting patient history and skin lesion imagery.
• To assess the diagnostic accuracy and inter-observer reliability of the developed TD mobile app.

Main Methods:

• A smartphone application was developed to gather clinical data and photographs from 89 dermatology patients.
• Diagnoses were established through in-person clinic assessments (gold standard).
• Three dermatologists independently evaluated app-recorded data, comparing their diagnoses to the gold standard using Kappa coefficient and agreement percentage.

Main Results:

• The most common skin lesions were located on the whole body (47%), with psoriasis (19.1%), acne vulgaris (11.2%), and eczema (10%) being prevalent.
• The overall inter-observer agreement among dermatologists was excellent, with a Kappa value of 0.856.
• The mobile app demonstrated high reliability in collecting diagnostic information.

Conclusions:

• The study supports the efficacy of a mobile app-based asynchronous teledermatology approach.
• This technology can serve as a valuable adjunct in areas with scarce dermatological services, such as Iran.
• Further research is recommended to solidify the reliability and practical application of TD.