For High-Risk Melanoma, Teledermatology May Shorten Wait Times to Biopsy

Compared with in-person appointments, teledermatology reduced the amount of time spent waiting to have a melanoma biopsied, according to study results presented at the 2023 Annual Meeting of the American Academy of Dermatology (AAD), held from March 17 to 21, 2023, in New Orleans, Louisiana.¹

The study also found that patients diagnosed via teledermatology had melanomas that were thicker and more mitotically active, and the researchers suggested that the shorter wait times to biopsy afforded by telehealth interventions could be critical for these higher-risk lesions.¹

“Studies have shown teledermatology is a promising tool to identify the majority of malignancies. However, little data exists to compare melanomas diagnosed by TD to those diagnosed through in-office visits,” the study authors commented.”²

A research team retrospectively reviewed 618 medical records of patients who were diagnosed with melanoma within a single health system between March 2020 and March 2022. The investigators collected data on tumor thickness, melanoma subtype, time from appointment scheduling to biopsy, visit type (in-person vs teledermatology), physician vs patient detection, and county of residence.¹

Nearly all (96.4%) of the melanomas were diagnosed during in-person visits, with only 3.6% diagnosed in patients who first presented via teledermatology. Patients who used teledermatology were younger than those who presented to an in-person appointment (median age, 55 vs 65 years, respectively; P =.0715).^1,2

Compared with those first seen during an in-person appointment, patients who were first seen via teledermatology experienced a significantly shorter time from first dermatology scheduling contact to lesion biopsy (73.8 vs 13.9 days, respectively; P =.0016).²

The melanomas experienced by patients who initially presented via teledermatology were more frequently invasive (68.2% vs 47.3%; P =.0544) and featured higher Breslow thickness (2.09 mm vs 0.85 mm; P =.0022) compared with those experienced by patients who presented in person. Melanomas experienced by patients who initially presented via teledermatology were also more frequently rare and were high-risk subtypes (nodular, 11.8% vs 5.5% and acral melanoma, 11.8% vs 1.5%; P =.0781).²

According to the researchers, teledermatology “may be particularly useful in higher-risk melanoma subtypes that are less efficiently identified through screening,” such as nodular, nevoid, and acral lentiginous melanomas. As such, the researchers noted that teledermatology “could be utilized as an effective tool for triage of self-identified concerning lesions.”

Disclosure: Some of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.