BT13 Teledermatology follow-up for low-risk lesions: surgical and histological outcomes from a 6-year cohort

Abstract

Teledermatology supports efficient triage for suspected skin cancer referrals. It is increasingly used for digital surveillance of low-risk lesions and assists timely decision making while avoiding unnecessary surgery. Data on teledermatology follow-up outcomes and recommended intervals for surveillance remain limited. We evaluated teledermatology follow-up outcomes for low-risk lesions among patients initially referred on the urgent skin cancer pathway. A retrospective analysis was conducted of patients with a teledermatology follow-up appointment between 2019 and 2025. Cases were categorized by outcome; those referred for surgery were further analysed for histological results and time interval between appointments. Of the 25 884 patients assessed, 2674 (10%) had teledermatology follow-up. The majority (1451, 54%) were discharged and 235 (9%) were referred for urgent surgery; of these, histology was available for 216 procedures. The majority (125, 58%) were benign lesions, 7 (3%) were cancerous (4 basal cell carcinomas, 1 squamous cell carcinoma and 2 malignant melanoma), 75 (35%) were dysplastic naevi, 4 (2%) were actinic keratosis and 5 (2%) were in situ disease. In the patients who had one teledermatology follow-up, the mean interval between the first appointment and teledermatology follow-up appointment was 4 months for benign lesions and 2.3 months for cancerous lesions. Teledermatology follow-up for low-risk lesions on the suspected skin cancer pathway delivers capacity gains by avoiding unnecessary face-to-face appointments and surgical procedures, particularly for atypical but stable lesions. Over half of patients were safely discharged following remote surveillance, reducing demand on outpatient clinics and minor operations. Most decisions to proceed to surgery followed a single teledermatology follow-up and were predominantly associated with benign histology. This study evaluates procedural outcomes following teledermatology surveillance, addressing an important evidence gap and informing national guidance on lesion selection and ­follow-up intervals within teledermatology.