Forum for Nordic Dermato-Venereology Nr 1, 2018 | Page 28

Teresa Løvold Berents – Atopic Dermatitis and Skin Barrier Function in Infancy and Early Childhood
of DHA. A follicular pigmentation was often found, somewhat
mimicking that of lentigo maligna.
Fig. 1. Smartphone used for teledermoscopy.
ance for both referral methods. The diagnostic agreement was
generally higher with TDS, with the largest difference seen for
melanoma. TDS also made it easier to plan for surgery at the
first visit and to resend referrals with clearly benign lesions.
However, a few TDS referrals with malignant lesions were
incorrectly resent.
In study III, two dermatologists compared the image qualityRof
172 dermoscopic images acquired in PHC with images of the
same tumours, obtained at the department of dermatology.
The PHC images were of slightly lower quality but the differ-
ence was not statistically significant. No difference was found
in the ability to correctly diagnose the lesions.
In study IV, dermoscopic images of skin lesions, obtained be-
fore and after the use of a sunless tanning product containing
dihydroxyacetone (DHA) were compared. For facial lesions,
there were significantly more equivocal lesions after the use
26
D issertation
In conclusion, TDS can result in safer, more efficient manage-
ment of patients with skin lesions of concern, earlier treatment
of patients with malignant lesions and fewer unnecessary
visits for patients with clearly benign lesions. TDS images
obtained in PHC are of similar quality to those obtained by
trained dermatologists. When triaging TDS referrals, dermatol-
ogists should avoid resending referrals for clinically atypical
melanocytic lesions and take into consideration the use of
pigment-altering substances such as DHA.
List of original publications
I. Börve A, Dahlén Gyllencreutz J, Terstappen K, Johansson Backman
E, Aldenbratt A, Danielsson M, et al. Smartphone Teledermoscopy
Referrals: A Novel Process for Improved Triage of Skin Cancer
Patients. Acta Derm Venereol 2015; 95: 186–190.
II. Dahlén Gyllencreutz J, Paoli J, Bjellerup M, Bucharbajeva Z, Gon-
zalez H, Nielsen K, et al. Diagnostic agreement and Interobserver
Concordance with Teledermoscopy Referrals. J Eur Acad Dermatol
Venereol 2017; 31: 898–903.
III. Dahlén Gyllencreutz J, Johansson Backman E, Terstappen K, Paoli
J. Teledermoscopy images acquired in primary health care and
hospital settings - a comparative study of image quality. J Eur Acad
Dermatol Venereol. 2017 Aug 29. [Epub ahead of print]
IV. Dahlén Gyllencreutz J, Bengtsson Boström K, Terstappen K. Does it
look like melanoma? A pilot study of the effect of sunless tanning
on dermoscopy of pigmented skin lesions. Br J Dermatol 2013;
168: 867–870.
Forum for Nord Derm Ven 2017, Vol. 22, No. 2