Background: Cutaneous melanoma is the leading cause of skin cancer-related mortality, and early detection is crucial to improving prognosis. Teledermatology (TD) has increasingly been adopted in melanoma care to address growing demand and limited access to specialists. This systematic review aimed to evaluate the role of TD in the diagnosis and management of suspected melanoma under real-world clinical conditions. Methods: The review was conducted and reported in accordance with the PRISMA 2020 guidelines. Literature searches were performed in PubMed, Embase, Web of Science, and Scopus up to December 2024. Studies assessing TD use in routine practice were included, focusing on diagnostic accuracy, prognostic indicators, waiting times, satisfaction, and economic outcomes. Results: TD showed high sensitivity and specificity, particularly when dermoscopic images and expert interpretation were available. Some studies reported reduced Breslow thickness and shorter delays compared to face-to-face care. Overall satisfaction was high among both patients and clinicians. Economic evaluations suggested potential cost savings, although formal analyses were limited. The use of artificial intelligence tools yielded mixed results and was generally perceived with caution in the absence of clinical supervision. Conclusions: Teledermatology appears to be a useful approach for improving access and supporting early diagnosis in melanoma care. Its effectiveness depends on proper implementation and integration into clinical workflows.
背景：皮肤黑色素瘤是皮肤癌相关死亡的主要原因，早期检测对改善预后至关重要。远程皮肤病学（TD）在黑色素瘤诊疗中的应用日益广泛，以应对日益增长的需求和专科医生资源有限的现状。本系统综述旨在评估TD在真实临床条件下对疑似黑色素瘤的诊断和管理作用。方法：本综述按照PRISMA 2020指南进行和报告。文献检索截至2024年12月，覆盖PubMed、Embase、Web of Science和Scopus数据库。纳入评估TD在常规实践中应用的研究，重点关注诊断准确性、预后指标、等待时间、满意度及经济性结果。结果：TD显示出较高的敏感性和特异性，尤其在提供皮肤镜图像和专家解读的情况下。部分研究报道，与面对面诊疗相比，TD可降低Breslow厚度并缩短诊疗延迟。患者和临床医生的总体满意度均较高。经济性评估提示其具有潜在的成本节约效益，但正式分析仍有限。人工智能工具的应用效果不一，在缺乏临床监督的情况下普遍受到谨慎对待。结论：远程皮肤病学似乎是改善黑色素瘤诊疗可及性、支持早期诊断的有效方法，其效果取决于在临床工作流程中的恰当实施与整合。
Teledermatology vs. Face-to-Face Dermatology for the Diagnosis of Melanoma: A Systematic Review
肿瘤(癌症)患者之家