The role of dermatopathology in conjunction with teledermatology in resource‐limited settings: lessons from the African Teledermatology Project
Open accessAbstract
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.
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- Authors
- Tsang, M. W., & Kovarik, C. L.
- Affiliations
- University of Minnesota (US)
- University of Pennsylvania (US)
- Corresponding author
- Kovarik, Carrie L.
- ORCID
- Kovarik, Carrie L.
- Venue
- International Journal of Dermatology
- Publisher
- Wiley
- Published
- 2011-02
- Volume
- 50
- Issue
- 2
- Pages
- 150-156
- ISSN
- 0011-9059 (ISSN-L)
- 1365-4632
- PMC
- PMC3760682
- OpenAlex
- W1913687380
- Cited by
- 50
- References
- 13
- Citations by year
- 2025: 2 · 2024: 4 · 2023: 2 · 2022: 3 · 2021: 5 · 2020: 3 · 2019: 5 · 2018: 2 · 2017: 3 · 2016: 2 · 2015: 9 · 2014: 6 · 2013: 2 · 2012: 1
- FWCI
- 4.26
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- International Journal of Dermatology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- University of Pennsylvania
- National Institute of Allergy and Infectious Diseases (P30AI045008)
- Topics
- Health Sciences › Medicine › Dermatology › Medicine and Dermatology Studies History
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Medicine › Oncology › Cutaneous Melanoma Detection and Management
- Keywords
- dermatopathology, teledermatology, resource-limited settings, skin biopsy, clinicopathological correlation, Kaposi's sarcoma, skin malignancies, skin infections, dermatological diagnosis, teleconsultation
- MeSH terms
- Dermatology, Female, Government Programs, Humans, Male, Retrospective Studies, Skin Diseases, Program Evaluation, Telemedicine, Africa South of the Sahara
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