In order to keep pace with the explosion of digital teledermatology technology, a new and expanding Teledermatology Subcommittee has been established at the BAD, whose role is to support departments to develop and optimise safe and effective teledermatology services.
The British Teledermatology Subcommittee aims to provide members with access to a central support team for any issues relating to digital dermatological care. The subcommittee includes consultants, primary care and patient representatives and trainees from across the UK.
BAD Position Statement on Teledermatology
The committee previously existed as The British Teledermatology Society, which was instrumental in developing national guidance:
Quality Standards for Teledermatology
UK guidance on the use of mobile photographic devices in dermatology
The teledermatology team are working closely with national organisations such as NHS England, NHSX and NHS Digital, the Care Quality Commission and the Elective Care Transformation teams on issues relating to teledermatology delivery, training, commissioning and tariffs. Regular updates for BAD member will be published through the BAD newsletter
Teledermatology update Summer BAD newsletter 2019
*Copyright (2019), British Association of Dermatologists. No part of this publication may be reproduced, stored or used in any way, without prior permission in writing of the Editorial team.
Teledermatology can be delivered using the NHS national e-Referral service (e-RS) as
a potential alternative to referral, using the Advice and Guidance (A&G) functionality.
a tool for triage of referrals, using the Referral Assessment Service (RAS) functionality.
Images can be attached to advice and guidance requests and referral assessment service referrals.
A national Advice and guidance toolkit has been launched in July 2019 to support clinicians, commissioners and service managers in developing and optimising advice and guidance services across a wide range of specialities, including dermatology.
Link to Advice and Guidance toolkit
Example of e-RS teledermatology consent form
A range of commercial platforms offer teledermatology functionality. The BAD subcommittee aim to maintain an overview of use of these platforms across the UK to provide impartial advice and feedback from users across the country. Commercial teledermatology platforms include;
*Despite listing these commercal platforms they are not endorsed by the BAD.
The Royal College of General Practitioners has published a Dermatology Toolkit which includes top tips on taking both dermoscopic and general dermatology images
Top Tips: Getting started with using a dermatoscope
Top Tips: Using personal mobile devices to take photos
Top Tips: How to take good dermatology photos
The British Teledermatology Subcommittee is working closely with the BAD's Education Subcommittee to ensure that the current dermatology curriculum reflects the ever changing digital role of the consultant dermatologist, and equips trainee dermatologists with the skills to deliver digital patient care safely and effectively.
Dermatology trainees can apply annually for the BAD Teledermatology Subcommittee Fellowship
The Subcommittee awarded two travel fellowships to attend the 24th World Congress of Dermatology in Milan, June 2019. The recipients were Dr Angela Alani and Dr William Hunt, who have provided reports on the Congress and in particular the Teledermatology session below:
Dr Alani report
Dr Hunt report
The committee will be awarding two more fellowships for the World Congress of Teledermatolgy in Seville 2020 (details to follow).
The annual course teledermatology training course is open to dermatologists, commissioners and general practitioners with an interest in teledermatology. The next course will take place at Willan House, London on Thursday 31 October – Friday 1 November 2019. Please click here for more information.
The Annual British Teledermatology meeting and AGM will take place in July 2020 in Manchester.
Carolyn Charman (Chair) Beth Wright
Saul Halpern Zeeshan Hasan
David de Berker Sarah Mehrtens
Pawel Bogucki Alice Walker
Louise Fearfield Lucy Thomas
Kathy Thomson Marilyn Benham
Richard Motley Tania Von Hospenthal
Irshad Zaki Andy Widelski
Helen Frow Paul Callaghan
Dermoscopy (also called dermatoscopy), refers to the examination of the skin using skin surface microscopy. It is mainly used to evaluate pigmented lesions in order to distinguish malignant skin lesions, such as melanoma and pigmented basal cell carcinoma, from benign melanocytic naevi and seborrhoeic keratosis.Dermoscopy is also useful in the diagnosis of non-pigmented skin lesions and inflammatory dermatoses.
This year, the Royal College of General Practitioners launched a Dermatology toolkit,which champions dermatoscopy. In an effort to improve the quality of referrals and reduce unnecessary appointments in secondary care, Clinical Commissioning Groups are investing in dermatoscopes for primary care to use where appropriate. GPs should be trained in how to take clear photographic images to send with the patient referral. They are not required to make a diagnosis which would require accredited training to be de demonstrated.
Dermoscopy requirements include a high quality lens for 10 to 14-times magnification and a lighting system (a dermatoscope). This enables visualisation of subsurface structures and patterns. Hand-held devices are usually lightweight and battery-powered.
Dermatoscopes vary in quality, build, and features, and hence in cost. There are several manufacturers and suppliers of dermatoscopes which are available for purchase from NHS Supply Chain which can be reviewed here.
Computer software can be used to archive the images and allow remote diagnosis and reporting by a dermatologist (digital epiluminescence microscopy, teledermoscopy, mole mapping).
Digital whole body imaging can be used for mole mapping, i.e. precisely locating an individual lesion that has been imaged by macro or dermoscopic photography. It is not necessary to individually photograph every lesion. Patients should be referred to their local dermatology department for mole mapping where clinically appropriate.
British Association of Dermatologists
4 Fitzroy Square
London, W1T 5HQ
NHS England National e-Referrals Secondary Care Clinical Lead