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Asynchronous 3D Photography Is a Reliable Tool for the Assessment of Mycosis Fungoides Clinical Severity
Kelvin Truong1,2, James Elhindi3, Raquel Ruiz Araujo1,2
1Department of Dermatology, Westmead Hospital, Westmead, New South Wales, Australia.
Background:
Mycosis fungoides (MF) requires accurate clinical assessment for staging and management. Teledermatology aids remote evaluations, but there is limited data on the use of 3D total body photography (TBP) in assessing MF.
Objective:
This study evaluates the accuracy and reliability of assessing a patient with MF using 3D TBP compared to in-person review.
Methods:
Thirteen MF patients were evaluated in-person using the modified Severity Weighted Assessment Tool (mSWAT) by two dermatologists, and then had 3D TBP taken. 8 weeks later, the dermatologists evaluated the virtual images. Three independent dermatologists reviewed the virtual images twice, 8 weeks apart. Intraclass correlation coefficients (ICC) assessed agreement between in-person and virtual assessments and test-retest reliability.
Results:
There was moderate agreement (ICC = 0.71) for intra-rater in-person and virtual assessments. Test-retest reliability of virtual assessment was good (ICC = 0.79). Evaluating inter-rater agreement between in-person and virtual assessments indicated good agreement (ICC = 0.80).
Limitations:
3D TBP could not capture skin on the scalp, beneath clothing and on the soles of the feet, limiting complete assessment.
Conclusion:
Clinical assessment of mSWAT using 3D TBP is as reliable as in-person mSWAT, suggesting its potential in teledermatology. Further studies are needed to validate these findings in larger cohorts.

