Prospective observational comparative study assessing the role of store and forward teledermatology triage in skin cancer

In the UK, patients with suspected cancer should be seen within 2 weeks of referral, and treatment commenced within 62 days. We investigated store-and-forward teledermatology triage for melanoma and squamous cell carcinoma (SCC) at a skin-cancer clinic. Electronic referral and digital photography were assessed together to allocate priority. Data were collected prospectively for 1 year and compared with conventional referral. In the photograph group, we upgraded all patients with malignant lesions who were not referred urgently. In the comparison group, seven patients (9%) were not upgraded and six (8%) were downgraded. Median wait to clinic for photographed patients with melanoma was 14 days and 13.5 days for SCC. Without photographs, urgent cases were seen after a median of 24 days. In the photograph group, all but one melanoma and 60% of patients with SCC were treated within 62 days. In the group without photographs, 68% of patients with melanoma and < 50% of patients with SCC were treated within 62 days. These data support photographic triage as a useful tool for improving prioritization and reducing waiting times.