What is teledermatology?
The Teledermatology service is being provided at local hubs where a qualified professional clinical photographer will take a series of digital photographs of your skin lesion. These photographs will be sent to a dermatologist for remote assessment to see if you need to come into hospital for further treatment. You will not have a face-to-face consultation with a doctor at this appointment.
Clinics run in partnership with Skin Analytics, an external company who will support the assessment of your skin lesion using a specially developed computer program called DERM. DERM has been developed by Skin Analytics to recognise skin cancer and common harmless skin conditions using photographic images to recognise some kinds of skin cancer and common harmless skin conditions.
You may have been referred from your GP or via another route to have either a single or two specific lesions photographed. If you have been referred for more than two lesions, you will be asked to seek another route for treatment, or be re-referred for your other lesions via your GP. Please note, only lesions that are documented on your referral can be photographed during your appointment.
The photographer may use two different devices:
- a camera phone which uses a computer program (DERM) to analyse the lesion to see if you need to see a dermatologist, and
- a professional digital camera
They will photograph a general view of the area of interest to establish the location of your lesion, and a detailed close up using a specialised lens called a dermatoscope. The dermatoscope allows the photographer to capture highly detailed images of your lesion, by pressing gently against the surface of the skin. This should not hurt.
It may not be possible to photograph some lesions using the dermatoscope. This will be explained to you at your appointment.
Once the photography is complete, your images will be securely saved and uploaded to your electronic patient record. Images taken on the Skin Analytics device will be encrypted and electronically transferred, by secure means, so they can be analysed by DERM. The software will then provide a recommendation on whether or not the lesion needs to be seen by a dermatologist at University Hospitals Birmingham NHS Foundation Trust (UHB). The Dermatology team will assess the report and review your clinical photographs. They will then contact you, usually within 21 working days, to advise if you need to come into hospital for further treatment.
If you are concerned about any other lesions or skin problems, please seek advice from your GP.
Some lesions will not be suitable for assessment by the Skin Analytics technology called DERM. This includes lesions that are covered in hair or are under nails. On the day of the clinic, the clinical photographer will identify any lesion which should be excluded from DERM analysis. If this is the case, images of the lesion will still be taken, and the team will still take your medical and lesion-specific history. The only difference is that the images will be assessed manually by UHB dermatologists, rather than using DERM. The dermatologists will then contact you to let you know if a further appointment is needed.
How long will my appointment take and what will happen?
You will be asked a series of questions detailing your medical history and specific details of the lesion itself. The photographer will explain what photographs need to be taken to assess your lesion before they proceed. If you have any questions about the photography, please do not hesitate to ask.
Please note you may be asked to remove jewellery or make up where necessary. Depending on the location of your lesion, you may also be asked to remove articles of clothing to gain a better view of the area of interest. If you are required to remove clothing to show a sensitive area of your body, you may request a chaperone. This whole process will take approximately 25 minutes.
More information on what to expect during your visit can be found on the appointments page.
Do I need to give permission for photographs to be taken?
The clinical photographer will discuss consent with you in detail to ensure you are comfortable with the photographs being taken and how your clinical images will be used. If you are happy to proceed, you will be required to provide:
- written consent for clinical photography, and
- verbal confirmation of your consent for the Skin Analytics website
We will not take any photographs without your permission.
You may withdraw your consent at any time by contacting the Clinical Photography department. Clinical photographs that have been used to make a clinical decision cannot be deleted, however your images can be retracted and hidden from view on your electronic patient record.
Retracting consent will not affect your treatment or any future treatment you may receive.
Any photographs you have previously authorised for open publication may not be able to be withdrawn from publications already in the public domain.
How is my data used by Skin Analytics?
To process your assessment, Skin Analytics securely store your medical history data and images, together with standard identification information necessary for the safe and accurate filing of the assessment report (i.e. your name, date of birth and NHS number).
The assessment report will be available for University Hospitals Birmingham NHS Foundation Trust to use appropriately in support of any further care you may need.
The results of the assessment will be sent to your GP practice to be included in your medical records.
The assessment may be reviewed for quality assurance purposes by Skin Analytics or other authorised bodies. This data may include information collected during the assessment and any subsequent diagnoses relating to the lesions assessed.
Skin Analytics ask for your consent to use your data for research purposes to improve their service. Where data relating to your assessment is used for research purposes, it will be anonymised.
What happens after my photographs have been reviewed?
After reviewing your photographs, the dermatologist may offer you further treatment and contact you and your GP with a letter about your lesion management or offer you a face-to-face or virtual appointment.
How will I find out the result of this photographic procedure?
You should receive a letter in the post within two to three weeks of your visit or a telephone call asking you to attend a face-to-face consultation.
If you have not heard from the team, or are concerned about changes in your lesion, please contact them.
If an outcome cannot be determined you may be asked to:
- book a biopsy (skin sample) or the removal of the skin lesion
- book a priority face-to-face clinical appointment with a dermatologist in hospital
- have a virtual video or telephone consultation
If there is no indication of anything serious, you may be offered reassurance:
- and a routine follow up appointment in Dermatology, which may require photographs to be repeated
- by a clinical letter with no follow up appointment required and you will be discharged
If you require non-urgent treatment, the Dermatology team may contact your GP to arrange treatment for you.
Does an urgent follow up appointment or surgery mean I have cancer?
No. You could be asked to come back urgently for a number of reasons. Urgent appointments will generally be seen within a few weeks, so there should not be a long wait.
Can I have copies of the photographs?
Yes. You can do this by sending a request to the Access to Health Records department. You will be required to provide your:
- date of birth
- hospital registration number (if known)
- hospital where you are being treated
Full details are available on the access to health records page.
When should you worry about a mole?
It is important to check your skin regularly for any change. You may want to ask a family member or a friend to examine your back.
Following the ABCDE – easy rules can help you identify potentially worrying features:
- Asymmetry – the two halves of the lesion may differ in shape
- Border – edges of the lesion may be irregular, blurred or notched
- Colour – the colour may be uneven
- Diameter – report any mole larger than 6mm or a change in size or shape
- Evolution – changes in size, shape, colour or elevation or any new symptom such as bleeding, itching or crusting
It can be helpful to take images of your lesion to see if the lesion is changing over time as it can be more reliable than using memory alone. It can be useful to do this every few months using a phone with a camera.
If you notice any of the changes described above or are concerned about a mole or patch of skin for any other reason then contact your GP as soon as possible.
How can you reduce your risk of skin cancer?
It is recognised that unprotected exposure to UV radiation can increase your risk of skin cancer. It is therefore important to be careful in the sun.
The British Association of Dermatologists (BAD) have compiled the following ‘Top Sun Safety Tips’:
- Protect your skin with adequate clothing, wear a hat that protects your face, neck and ears, and a pair of UV protective sunglasses
- Choose sun protective clothing (with permanently sun-protective fabric, widely available for adults and children) if you have fair skin or many moles
- Spend time in the shade between 11:00 – 15:00 when it’s sunny
- Step out of the sun before your skin has a chance to redden or burn
- When choosing a sunscreen look for a high protection SPF (current recommendations are SPR 50 or 50+) to protect against UVB, and the UVA circle logo and/or 4 or 5 UVA stars to protect against UVA
- Apply plenty of sunscreen 15 – 30 minutes before going out in the sun, and reapply every two hours and straight after swimming and towel-drying
- Keep babies and young children out of direct sunlight
- Sunscreens are not an alternative to clothing and shade, rather they offer additional protection (no sunscreen will provide 100% protection)
- Do not use sunbeds
Last reviewed: 26 August 2022