Telediagnosis and face-to-face diagnosis reliability for melanocytic and non-melanocytic 'pink' lesions

Background Telemedicine is a worldwide healthcare practice that, during the last years, has dramatically reduced the time of consultation for patients. Teledermoscopy aids in the current management of skin cancers in general and particularly of melanoma; telemedicine and teledermoscopy give the chance to provide consultations with experts also by long distance. Objective The purpose of this study is to determine the diagnostic reliability, according to interobserver agreement, between clinical and dermoscopic diagnosis of lesions with poor and/or absent pigmentation, comparing face-to-face diagnosis and telediagnosis. Materials and methods Forty-four lesions were examined by two different dermatologists with good and similar experience in the clinical field and dermoscopy. A store-and-forward teledermatological system, based on clinical and dermoscopic images, was done by the two skilled dermatologists. Results Our results underline that teledermoscopy of 'pink' lesions does not provide a similar degree of diagnostic accuracy as otherwise in face-to-face diagnosis perhaps due to the absence of typical criteria. Atypical skin lesions are characterized by the absence of typical dermoscopic patterns, and their teleconsultation does not always increase the diagnostic accuracy.