Teledermatology - BAD Patient Hub

What are the aims of this leaflet?

This leaflet has been written to help you understand more about teledermatology. It also explains how teledermatology can be used to help diagnose and manage patients with skin conditions.

What is teledermatology?

Teledermatology involves taking digital photographs of the affected skin. These photographs are then shared with a dermatology specialist (a healthcare professional specialising in skin conditions). The specialist then reviews the photographs and information about your medical condition. They can arrange appropriate treatment, tests or advice.

What are the benefits of teledermatology?

Teledermatology can help patients receive rapid, specialist advice or treatment for their skin condition. Teledermatology means you do not need to be in the same location as your specialist to receive their advice, and may avoid the need for you to travel to a hospital appointment.

In some cases, the specialist can communicate with you or your GP directly with a treatment plan or to reassure you that no treatment is needed. If the specialist recommends a hospital appointment or further tests, teledermatology helps them direct you to the right clinic, with the right healthcare professional and at the right time.

What does teledermatology involve?

Your healthcare professional will discuss the teledermatology process with you and answer any questions. They will ask for your verbal consent to take photographs of your skin condition as part of your clinical care. You may also be asked to sign a written consent form, which is required if your photographs are to be used for research or publication. Written consent is also required for identifiable photographs to be used for education of healthcare professionals.

What does giving my consent for teledermatology mean?

By giving consent to having the photographs taken, you are saying that you understand and agree to the reason for taking the photographs. Giving consent also means you understand that they will form part of your medical records. Your photographs will be stored according to Data Protection legislation.

Where will my teledermatology photographs be taken?

Sometimes, teledermatology photographs can be taken in your GP surgery. This can be done either by your GP or a member of the primary care team. In other cases, you may be offered an appointment in a teledermatology hub. This can be based either in the hospital or in a community setting, where photographs can be taken by a healthcare professional or a medical photographer. Examples of community settings include community hospitals or community diagnostic centres.

How many photographs will I have taken?

This will depend on your skin condition. Your healthcare professional will usually take three photographs of the affected skin area. One photograph will show the location on your body such as your arm, leg or back. Two more close-up photographs will provide enough detail for the dermatology specialist to decide on the next steps.

If you have a skin lesion (a lump or growth), your healthcare professional may take a photograph through a device called a dermatoscope. A dermatoscope magnifies the area of affected skin. It can help dermatology specialists diagnose skin cancer and other conditions. If you have a widespread rash on your body, your healthcare professional may recommend taking more photographs.

How will my photographs be sent to the dermatology specialist?

Your GP or referring healthcare professional will send your photographs and clinical history to the specialist. They will use a secure electronic pathway. Your healthcare organisation is responsible for ensuring that your photographs are sent and stored according to Data Protection legislation.

What happens after my photographs have been reviewed by the dermatology specialist?

In some cases, the dermatology specialist will be able to make a diagnosis from the photographs. They may also be able to provide advice and treatment recommendations to your referring healthcare professional without the need for you to travel to the hospital. The diagnosis and advice or treatment will be communicated to you by your GP team or specialist.

The specialist may decide you need to be seen in person in an outpatient clinic. In this case, you will be contacted and offered an appointment. Sometimes, the specialist will recommend a skin operation or skin biopsy. This is when a small piece of affected skin is removed and sent to a laboratory for diagnosis. If this is the case, you will be contacted with more information about skin surgery and a surgical appointment. You will also be provided with information about who to contact if you have any questions about the surgical procedure before your operation.

Can I take my own teledermatology photographs?

You are encouraged to take photographs of your skin condition. This can be particularly helpful if your skin condition is changing or coming and going. Please store your photographs on your mobile device and show them at your clinic appointment, if required. Your GP team or specialist may ask you to send your skin photos to them to help with your care. If you are asked to send photographs to a healthcare professional, they will advise you how to do this securely. The photographs can then form part of your medical records.

Follow these tips to take clear, effective photographs of your skin condition before sending them to your GP or specialist:

Use a plain background (for example, a blank wall or fabric sheet) to avoid distractions.
Ensure good, even lighting when taking the photographs. Avoid shadows over the area you are photographing.
Take an overview photograph to show the location of the affected area, followed by one or two close-up photographs for detail.
Focus is key to a good teledermatology photograph. Hold your phone at a moderate distance - too close a distance may cause blurriness. Most phones have an auto-focus feature, but if needed, tap the screen to manually adjust focus.
If you have a skin lesion, holding a ruler next to the area is helpful to document the size. You can use this photograph yourself to monitor the size of your lesion.
If the affected area is hard to reach, ask someone you trust to take the photograph for you.
Don't add any filters or edits to the photographs.

Is teledermatology suitable for all patients?

If your skin condition affects an intimate part of your body or is difficult to photograph (due to body hair, tattoos or scars), then teledermatology may not be suitable. Your clinical team will advise on the best way to assess your skin condition.

Is teledermatology always accurate?

In many cases, teledermatology can help provide an accurate diagnosis. It may also help provide a management plan for your skin condition. However, in other cases, your specialist may suggest a face-to-face appointment. This may be due to the nature of your skin condition, the quality of the photographs, or clinical information provided.

It is always important to remember that skin conditions can change over time. Please ask your healthcare professional for further advice if your skin condition does not improve following your teledermatology or face-to-face clinic appointment.

Where can I find out more about information about skin conditions while I wait for my teledermatology appointment?

The British Association of Dermatologists Patient Information Hub website provides a wide range of support and resources for patients and carers www.skinhealthinfo.org.uk/a-z-conditions-treatments/

NHS England patient guide for taking skin photographs (official NHS England YouTube channel): Taking photos of your skin and sending them securely to your GP

Jargon Buster: www.skinhealthinfo.org.uk/support-resources/jargon-buster/

Please note that the British Association of Dermatologists (BAD) provides web links to additional resources to help people access a range of information about their treatment or skin condition. The views expressed in these external resources may not be shared by the BAD or its members. The BAD has no control of and does not endorse the content of external links.

This leaflet aims to provide accurate information about the subject and is a consensus of the views held by representatives of the British Association of Dermatologists: individual patient circumstances may differ, which might alter both the advice and course of therapy given to you by your doctor.

This leaflet has been assessed for readability by the British Association of Dermatologists’ Patient Information Lay Review Panel.