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With 6.3 billion smartphone subscriptions estimated to be in use by 2021, the field of telemedicine and specifically teledermatology has begun a period of evolving growth and there is now widespread availability of skin cancer related dermatology applications (apps). The Aim of this review is to evaluate the benefits and limitations of skin cancer apps and teledermatology.
A variety of apps are available for public download. Examples of apps include teledermatology, photo storage, risk calculation, and educational apps. Apps that sent images directly to a dermatologist had the higher specificity and sensitivity (97% and 88% respectively). The second most effective apps (73% sensitivity and 83% specificity) use fractal theory analysis algorithms.
The benefits of teledermatology include education, encouragement of personal responsibility, effective triage, and provision of equitable services to remote areas. Early diagnosis results in up to 99% five-year survival, compared with 20% when diagnosed at stage 4. However, there is a lack of validation, regulation and scientific input into apps. Studies are required to evidence a safe and efficient teledermatology service in the UK.
As suggested by the British Association of Dermatology, teledermatology apps have benefits when integrated in care as a first step in early detection. Concerns regarding encryption of images and accountability for inaccurate diagnoses made by apps should be addressed. According to NICE, patients with potential skin malignancy should be seen in person by specialists. Therefore, apps can currently supplement but not substitute standard medical care.
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