Novel technology delivers remote detection of skin diseases

A recent study has shown the potential of the three-dimensional total body photography (3D TBP) in diagnosing general skin diseases, with high acceptance from both physicians and patients.

“Especially when considering the looming shortage of high-quality dermatological care, 3D TBP … has the potential to make more efficient use of healthcare resources by enabling underserved regions easier tele-access to dermatologists in better-served areas through better standardization of telemedicine,” the researchers said.

An observer agreement study was conducted to define the value of 3D TBP in general dermatology and to evaluate patient acceptance. Researchers compared diagnoses of 294 patients presenting with skin changes obtained in face-to-face visits with those obtained by retrospective analysis of 3D scans without seeing the patients face to face. Questionnaires were then used to assess patients’ views on 3D TBP.

Two senior dermatologists independently reviewing 3D TBP scans obtained primary diagnoses in a diverse group of patients across a broad range of diagnoses. Results matched in 68.4 percent and 81.1 percent of cases, respectively. [J Am Acad Dermatol 2025;93:1277-1283]

In terms of acceptance, patients gave mostly positive feedback on 3D TBP and identified major barriers, specifically shame and privacy, to this technology.

“Our results align with previously published diagnostic performance figures for 3D TBP in nonmelanoma skin cancer (NMSC) of 75 percent to 88 percent, albeit the other study used histology as a gold standard, whereas our study did not control for the mode of diagnosis,” the researchers said. [Dermatology 2024;240:142-151] 

“What is more, our results are among the highest accuracies seen in traditional 2D healthcare worker (HCW)-led teledermatology evaluations,” they added.

Direct comparison was not possible due to the different study designs and populations, but 3D TBP appeared to be as good as traditional HCW-led teledermatology for the diagnosis of skin diseases, with the benefit of a “hands-off” acquisition of image data. This eliminated the need for time-intensive training of HCWs and potential errors.

Shortcomings

“Based on the physicians’ experiences, qualitative shortcomings of this new technology for the diagnostic process lie in the inability to capture areas such as folds, soles, scalp, and mucosae and the inability to accurately display the nails because of frequent artifacts in this region,” the researchers said.

“Although in most cases, information on skin changes at these localizations is not needed, we observed that in many of the incorrectly diagnosed cases, these data would probably have led to the correct diagnosis, and improved accuracy,” they added.

Regardless of these shortcomings, patients expressed satisfaction with the workflow and noted the fast and comfortable acquisition as one of the strong points of the scanner. On the other hand, they also expressed concern about privacy and a feeling of shame during the scan.

“In our study, patients were generally open to the idea of triaging skin conditions using 3D TBP,” the researchers said.

“Further studies are needed to delineate its role in future dermatology health care with a diminishing number of dermatologists,” they added.