Keywords: Dermatoscopy, telemedicine, skin lesions

Background:

Our clinic is situated in a rural coastal area, with two branches located in East Lincolnshire, the second-largest county in England, spanning 6959 square kilometres. The area's geography, road infrastructure, and prolonged waiting times for initial outpatient dermatology appointments (ranging from 15 to 24 weeks) create significant barriers to timely patient care.
To improve accessibility, an advice and guidance (A&G) dermatology service has been implemented. For this service to effectively reduce the need for in-person appointments and enable clinicians to manage conditions within the community, it is essential to ensure the appropriate use of dermatoscopy and the ability to manage benign lesions without specialist intervention.

Aim of the study:

To assess the impact of a targeted educational intervention on teledermatology usage and staff confidence in recognising and managing specific skin lesions in the community.

Methodology:

A clinical audit was conducted to review referrals to A&G dermatology service and identify associated educational needs.
Following this, a targeted educational session was conducted to address areas for improvement and enhance the use of dermatoscopy. After the educational event, further analysis was performed on the utilisation of the teledermatology service over the subsequent two months.

Results:

Following the implementation of an educational intervention, early detection of basal cell carcinomas facilitated the treatment of 5 out of 11 cases within the community through non-surgical approaches. Approximately two-thirds of referrals to the A&G service were effectively managed within the practice, thereby eliminating the necessity for patients to travel to hospital facilities. Furthermore, the use of high-quality dermatoscopic images enabled specialists to distinguish between more advanced actinic keratosis and squamous cell carcinomas, thereby enhancing the availability of appointments within the cancer pathway.

Conclusions:

Teledermatology services, combined with education on skin lesions and dermatoscopy, enhanced community management of benign and early cancerous lesions, reducing the need for hospital appointments.