BACKGROUND: Access to dermatology and dermatopathology services is scarce in sub-Saharan Africa. Teledermatology provides consultations for healthcare providers in resource-limited settings where specialty medical services are difficult to obtain, and the African Teledermatology Project has helped to bridge the gap in dermatological care in Africa. This program also allows for biopsy specimens to be sent to the USA for processing in cases where the clinical diagnosis is difficult and definitive diagnosis has implications for patient management. This study characterizes conditions diagnosed through clinicopathological correlation in conjunction with photos and tissue submitted to the African Teledermatology Project. MATERIALS AND METHODS: Retrospective case review of tissue specimens submitted over three years. RESULTS: Fifty-five biopsy specimens met inclusion criteria and represent cases of malignancy (35%), infection (7%), suspected infection (15%), lichenoid tissue reaction (5%), dermatitis (15%), and other various conditions (18%). Three biopsy specimens were non-diagnostic (5%). Clinicopathological concordance between submitting clinician and biopsy results occurred in 32 out of 55 cases (58%). Clinical and pathological diagnoses differed in 21 out of 55 cases (38%). Kaposi sarcoma (KS) represents the clinical diagnosis most often suspected in the evaluated biopsy specimens (42%) and was correctly recognized clinically in 13 out of 23 cases (57%). CONCLUSION: Clinical images may not provide sufficient information to definitively diagnose certain infectious and malignant dermatological conditions submitted through telemedicine consultation. Microscopic examination of skin biopsy specimens is an important adjunct for accurate diagnosis of disease and determination of appropriate treatment strategies.
BACKGROUND: Access to dermatology and dermatopathology services is scarce in sub-Saharan Africa. Teledermatology provides consultations for healthcare providers in resource-limited settings where specialty medical services are difficult to obtain, and the African Teledermatology Project has helped to bridge the gap in dermatological care in Africa. This program also allows for biopsy specimens to be sent to the USA for processing in cases where the clinical diagnosis is difficult and definitive diagnosis has implications for patient management. This study characterizes conditions diagnosed through clinicopathological correlation in conjunction with photos and tissue submitted to the African Teledermatology Project. MATERIALS AND METHODS: Retrospective case review of tissue specimens submitted over three years. RESULTS: Fifty-five biopsy specimens met inclusion criteria and represent cases of malignancy (35%), infection (7%), suspected infection (15%), lichenoid tissue reaction (5%), dermatitis (15%), and other various conditions (18%). Three biopsy specimens were non-diagnostic (5%). Clinicopathological concordance between submitting clinician and biopsy results occurred in 32 out of 55 cases (58%). Clinical and pathological diagnoses differed in 21 out of 55 cases (38%). Kaposi sarcoma (KS) represents the clinical diagnosis most often suspected in the evaluated biopsy specimens (42%) and was correctly recognized clinically in 13 out of 23 cases (57%). CONCLUSION: Clinical images may not provide sufficient information to definitively diagnose certain infectious and malignant dermatological conditions submitted through telemedicine consultation. Microscopic examination of skin biopsy specimens is an important adjunct for accurate diagnosis of disease and determination of appropriate treatment strategies.
Authors: G P Lozzi; H P Soyer; C Massone; T Micantonio; B Kraenke; M C Fargnoli; R Fink-Puches; B Binder; A Di Stefani; R Hofmann-Wellenhof; K Peris Journal: J Eur Acad Dermatol Venereol Date: 2007-01 Impact factor: 6.166
Authors: M A B Trindade; N Y S Valente; M I P Manini; M D F Takahashi; C F D Anjos; G Benard; B Naafs Journal: J Clin Microbiol Date: 2006-10-04 Impact factor: 5.948
Authors: A Handisurya; A Rieger; Z Bago-Horvath; C Schellenbacher; A Bankier; A Salat; G Stingl; R Kirnbauer Journal: Sex Transm Infect Date: 2009-08 Impact factor: 3.519
Authors: Wah Cheuk; Kathy O Y Wong; Cesar S C Wong; J E Dinkel; David Ben-Dor; John K C Chan Journal: Am J Clin Pathol Date: 2004-03 Impact factor: 2.493
Authors: Rashid L Bashshur; Gary W Shannon; Trilokraj Tejasvi; Joseph C Kvedar; Michael Gates Journal: Telemed J E Health Date: 2015-09-22 Impact factor: 3.536
Authors: Christa Slaught; Victoria Williams; Surbhi Grover; Elizabeth Bigger; Mukendi Kayembe; Sebathu Chiyapo; Nicholas J Jackson; Scott Dryden-Peterson; Carrie L Kovarik; Karolyn A Wanat Journal: Int J Dermatol Date: 2018-11-21 Impact factor: 3.204
Authors: Katherine R Sabourin; Margaret Borok; Samantha Mawhinney; Maxwell Matimba; Francis Jaji; Suzanne Fiorillo; Dickson D Chifamba; Claudios Muserere; Busisiwe Mashiri; Chenjerai Bhodheni; Patricia Gambiza; Rachael Mandidewa; Mercia Mutimuri; Ivy Gudza; Matthew Mulvahill; Camille M Moore; Jean S Kutner; Eric A F Simões; Thomas B Campbell Journal: J Int AIDS Soc Date: 2022-08 Impact factor: 6.707