Does Teledermatology Enable Earlier Diagnosis of Cutaneous Squamous Cell Carcinoma Than Face-to-face Consultation?

Teledermatology has become increasingly relevant for skin cancer diagnosis, particularly following the COVID-19 pandemic. This retrospective study assessed whether teledermatology enables earlier diagnosis of cutaneous squamous cell carcinoma (cSCC) compared with conventional face-to-face consultation. Clinical and histopathological data from 224 patients (101 in 2019; 123 in 2022) were analysed. Referral delays decreased from 55 to 3 days and surgical wait times from 28.7 to 12.3 days. Tumours diagnosed via teledermatology had significantly smaller minor diameters (0.56 ± 0.3 cm vs 1.09 ± 0.5 cm; p < 0.001). Al-though maximum diameter and tumour depth did not differ significantly, the smaller tumour surface area in the teledermatology group suggests diagnosis at an earlier clinical stage. In multivariate analysis, minor diameter was the strongest independent predictor of teledermatology-based diagnosis (OR = 0.01, 95% CI: 0.001-0.02). These findings suggest that teledermatology facilitates earlier diagnosis of cSCC, allowing timely treatment and potentially reducing the need for extensive surgical procedures. Teledermatology should be considered a valuable triage tool for skin cancer detection, particularly in health systems with limited access to dermatological care.