Solidarity and Voluntarism Amid the COVID-19 Pandemic: Skin Cancer Screening for Blood Donors

Abstract The UK healthcare system has been profoundly affected by the COVID‐19 Pandemic, including skin cancer departments. Despite service capacity and a worldwide increase in incidence, anecdotal reports suggest a decline in skin cancer diagnoses following COVID‐19. To determine if there is a decrease in skin cancer diagnosis in the UK in the COVID‐19 era, we analysed data from the Northern Cancer Network from March 23rd 2020 to June 23rd 2020 and compared it to the same period last year. In the COVID Period there was a decrease in skin cancer diagnoses of 68.61% from 3619 to 1136 (p<0.0028). Surprisingly, skin cancer waiting times were also reduced in the COVID Period compared to Before COVID Period (median 8 days and 12 days respectively; p<0.0001). Collectively these data highlight a statistically significant reduction in both skin cancer diagnoses and waiting times during the COVID Period. Show more

Background: Teledermatology offers an opportunity to continually deliver care during the coronavirus disease 2019 pandemic. Objective: To provide quantitative data about the use of teledermatology. Methods: Retrospective analysis of teledermatology consultations was performed from March 16 to May 1, 2020. The number/type of encounters, differences in diagnoses, and prescriptions between asynchronous and synchronous teledermatology visits were analyzed. Results: A total of 951 visits (36.2%) were asynchronous whereas 1,672 visits (63.8%) were synchronous. Only 131 (<5%) visits required an acute in-person follow-up. The diagnosis of acne was more frequent with asynchronous visits (p < 0.002, Bonferroni corrected). Antibiotics and nonretinoid acne medications were prescribed more with asynchronous visits, whereas immunomodulators and biologics were more commonly prescribed with synchronous visits (p < 0.02, Bonferroni corrected). Providers at our institution were split on preferred mode (54.2% synchronous, 45.8% asynchronous); however, synchronous visits were preferred for complex medical dermatology patients and return patients (p < 0.05). Limitations: This study is limited by being a single-center study. Conclusions: Asynchronous teledermatology was used more for acne management, whereas synchronous teledermatology was preferable to providers for complex medical dermatology. Postanalysis of the data collected led us to institute a hybridization of our asynchronous and synchronous teledermatology. Show more

Recent studies investigated the value of teledermatology (TD) as a valid tool for a dermatologist-directed triage systems. To investigate the feasibility of a store-and-forward TD triage system in a large number of patients. Previously trained general practitioners selected suspicious skin tumours in the setting of a general preventive medicine screening programme and transmitted their dermoscopic images via virtual private network for decision-making. Within 48 h, two teleconsultants highly experienced in dermoscopy first assessed image quality, then made a diagnosis and answered if lesions were to follow-up, to excise or to be re-evaluated at face-to-face (FTF). A total of 955 lesions were telediagnosed [743 (78%) benign melanocytic, six (0.6%) malignant melanocytic, 186 (19%) benign non-melanocytic and 20 (2%) malignant non-melanocytic]. Excision was recommended for 111 (12%) lesions, 10 lesions (1%) were referred to FTF examination. Follow-up was recommended for 707 (74%) lesions. The vast majority of the lesions (82%) were screened as benign and an intervention was requested in only 18% of cases. Eighty-two patients (12% of the total) were lost at follow-up. The diagnostic accuracy was of 94% with sensitivity of 100% and specificity of 95.8%. We confirm that TD is suitable to triage skin cancers. © 2013 European Academy of Dermatology and Venereology. Show more