BT12 An audit of teledermatology vs. face-to-face dermatology review: follow-up rates and management outcomes at a tertiary centre

Abstract

Teledermatology is an integral component of dermatology services, improving access to care and facilitating timely triage. Teledermatology has been widely used within our tertiary centre dermatology department to reduce waiting times and streamline patients to appropriate surgical pathways. In July 2024, its use was expanded to include urgent suspected skin cancer referrals. Evaluation of its clinical effectiveness compared with face-to-face review remains essential. This study was designed to compare management outcomes of virtual assessment with in-person consultations in 2-week-wait (2WW) urgent suspected skin cancer clinics. This retrospective audit compared outcomes for 63 patients (71 lesions) assessed via Ederma and 63 patients (69 lesions) seen in face-to-face 2WW urgent suspected skin cancer clinics between September and October 2025. A stratified consultant sample was used to minimize clinician-related bias. Data collected included initial management decisions, requirement for follow-up (including patient-initiated follow-up), discharge rates and changes in management following subsequent review. Clinic follow-up was required in 11% (7 of 63) of teledermatology patients, most commonly due to inflammatory lesions, small lesion size, assessing treatment response or administering cryotherapy. This was comparable with the face-to-face cohort (11%, 7 of 63), with an additional 3% (2 of 63) offered patient-initiated follow-up. Discharge rates were similar: 21% (13 of 63) for virtual assessments and 24% (15 of 63) for face-to-face. There was no significant difference in requests for surgical management between the face-to-face (44 of 69, 64%) and teledermatology cohorts (45 of 71, 63%; P = 0.96). Only 2% (1 of 63) of teledermatology patients required subsequent in-person review, and 2% (1 of 63) had a change in management following face-to-face review in clinic. Virtual assessment demonstrated outcomes comparable with face-to-face 2WW clinics in terms of follow-up, discharge and surgical management, with minimal subsequent change in management following review in person. These findings support its safety and effectiveness as a triage tool for urgent suspected skin cancer referrals. Further analysis is underway to assess diagnostic concordance between cohorts based on histological outcomes.