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This systematic review compares teledermatology with conventional face-to-face dermatology to define advantages, limitations, and diagnostic workflow roles for patients and physicians. 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Vaiopoulos 3, Ioannis Georgopoulos 2,4, Eleni Papakonstantinou 5, George Gaitanis 6 and Christos C. Zouboulis 1  \nCitation: Nikolakis, G.; Vaiopoulos,  \nA.G.; Georgopoulos, I.;  \nPapakonstantinou, E.; Gaitanis, G.; Zouboulis, C.C. Insights, Advantages, and Barriers of Teledermatology vs. Face-to-Face Dermatology for the Diagnosis and Follow-up of  \nNon-Melanoma Skin Cancer: A Systematic Review. Cancers 2024, 16, 578. [https://doi.org/10.3390/](https://doi.org/10.3390/)[ ](https://doi.org/10.3390/)cancers16030578  \nAcademic Editor: Reinhard Dummer  \nReceived: 4 October 2023  \nRevised: 21 January 2024  \nAccepted: 24 January 2024  \nPublished: 30 January 2024  \nCopyright: © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) .  \n1 Departments of Dermatology, Venereology, Allergology and Immunology, Staedtisches Klinikum Dessau, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, 06847 Dessau, Germany; [christos.zouboulis@mhb-fontane.de](christos.zouboulis@mhb-fontane.de)  \n2 Docandu Ltd., London N8 0ES, UK; [ioannis.georgopoulos@med.uoa.gr](ioannis.georgopoulos@med.uoa.gr)  \n3 Second Department of Dermatology and Venereology,“Attikon” University General Hospital, National and Kapodistrian University of Athens, 12462 Athens, Greece; [avaiopoulos@gmail.com](avaiopoulos@gmail.com)  \n4 Surgical Department,“Agia Sofia” Children’s Hospital, 11527 Athens, Greece  \n5 Private Practice of Dermatology, 19100 Attiki, Greece; [elenipap2000@hotmail.com](elenipap2000@hotmail.com)  \n6 Department of Skin and Venereal Diseases, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; [ggaitan@uoi.gr](ggaitan@uoi.gr)  \n* Correspondence: [georgios.nikolakis@mhb-fontane.de](georgios.nikolakis@mhb-fontane.de); Tel.: +49-340-501-4013  \nSimple Summary: This systematic review investigates the diagnostic concordance, advantages, and barriers of teledermatology in comparison to face-to-face dermatology for the diagnosis, management plan, and follow-up of non-melanoma skin cancer. Factors of increasing its sensitivity (teledermoscopy, quality of images, artificial intelligence, experience in generating clinical and teledermoscopy images) and its role as a tool for non-melanoma skin cancer triage for both underserved and high-risk populations are discussed.  \nAbstract: Background: Teledermatology is employed in the diagnosis and follow-up of skin cancer and its use was intensified during and after the COVID-19 pandemic. At the same time, demographic changes result in an overall increase in non-melanoma skin cancer and skin precancerous lesions. The aim of this study was to elucidate the role of teledermatology in comparison to conventional face-to-face dermatology for such lesions and determine the advantages and limitations of this workflow for patients and physicians. Methods: Research was performed using relevant keywords in MEDLINE and CENTRAL. Relevant articles were chosen following a predetermined standardized extraction form. Results: Diagnostic accuracy and interrater/intrarater agreement can be considered comparable—although lower—than in-person consultation. Improvement of particular features such as image quality, medical history availability, and teledermoscopy can further increase accuracy. Further aspects of limitations and advantages (mean time-to-assessment, time-to-treatment, costeffectiveness) are discussed. Conclusions: Teledermatology has comparabl","cbCaivUcMrmwvVWg","https://ap.wps.com/l/cbCaivUcMrmwvVWg","pdf",561151,"English","# Introduction\n## Teledermatology background and rationale\n## Forms of teledermatology (store-and-forward vs synchronous)\n## Diagnostic and workflow considerations\n# Methods\n## Literature search and article selection\n## Extraction process and outcomes\n# Results\n## Diagnostic accuracy and agreement\n## Factors improving sensitivity\n## Time-to-assessment, time-to-treatment, and cost-effectiveness\n# Discussion\n## Advantages and limitations for patients and physicians\n# Conclusions\n## Role in triage and follow-up","[{\"question\":\"How does teledermatology compare with face-to-face dermatology in diagnostic accuracy for non-melanoma skin cancer?\",\"answer\":\"Diagnostic accuracy and interrater/intrarater agreement are considered comparable, though lower than in-person consultation. Accuracy can improve with better supporting factors such as image quality and teledermoscopy.\"},{\"question\":\"Which factors are discussed as increasing teledermatology sensitivity?\",\"answer\":\"The review discusses improved image quality, availability of medical history, teledermoscopy, and additional experience generating clinical and teledermoscopy images, including the potential role of artificial intelligence.\"},{\"question\":\"What are the reported practical advantages and limitations of teledermatology workflows?\",\"answer\":\"Advantages include easier access to dermatologic consultation and shorter mean times to diagnostic biopsy and/or treatment, supported by cost-effectiveness. Limitations include reduced sensitivity compared with in-person consultation, with workflow performance influenced by available information and imaging quality.\"}]","Insights, Advantages, and Barriers of Teledermatology vs. Face-to-Face Dermatology for the Diagnosis and Follow-Up of Non-Melanoma Skin Cancer - A Systematic Review | PDF",1789975624]