[External scientific evaluation of the first teledermatology app without direct patient contact in Germany (Online Dermatologist-AppDoc)]. / Externe wissenschaftliche Evaluation der ersten Teledermatologie-App ohne direkten Patientenkontakt in Deutschland ("Online Hautarzt ­ AppDoc").

BACKGROUND: Teledermatology addresses the problems associated with the lack of specialists and the often long waiting time for an appointment with a dermatologist. The research project Online Dermatologist-AppDoc enables a fast anonymous expert opinion and was approved on 22 October 2018 by the Landesärztekammer Baden-Württemberg for 2 years as a model project. OBJECTIVES: The aim of the present work is the presentation of the first real healthcare data for German teledematology within the framework of the external quality assurance of the model project Online Dermatologist-AppDoc. MATERIALS AND METHODS: Anonymous data records submitted to Online Dermatologist-AppDoc between 21 November 2018 and 1 August 2019 were analyzed qualitatively and quantitatively at the Department of Dermatology of the University Hospital Essen. In addition to the evaluation of the data records submitted so far, 100 cases submitted underwent a second assessment by a board-certified dermatologist to assess concordance. RESULTS: A total of 1364 cases (60.4% men, 39.6% women) were included in the current first external scientific evaluation. In 90.3% of the cases, remote diagnosis was possible. The two most frequent diagnoses were different forms of eczema (n = 270) and nevi (n = 163). Almost two thirds of the patients (64.3%) could be treated teledermatologically only. The random second examination of 100 cases resulted in an agreement of the diagnosis including the differential diagnosis/diagnoses in 97% of the cases. CONCLUSIONS: The first external scientific evaluation of the teledermatological model project Online Dermatologist-AppDoc indicates that the reduction of spatial and temporal barriers of a dermatological examination as well as the teledermatological triage have been so far successful.

Modified Mohs micrographic surgery in the therapy of dermatofibrosarcoma protuberans: analysis of 22 patients.

BACKGROUND: Dermatofibrosarcoma protuberans (DFSP) is a very rare, low-grade malignant tumor. Local recurrence is frequent after incomplete resection either because of false diagnosis or inadequate standard surgical excision. This study evaluated the clinical outcome of micrographic surgery with paraffin sectioning in the therapy of DFSP. METHODS: Medical charts of 22 patients with histologically confirmed DFSP treated at our institution between 1987 and 2002 were reviewed. RESULTS: For 13 patients with primary and 9 with recurrent disease, tumor-free excision margins could be achieved, and all patients remained free of local recurrence during a mean follow-up of 54 months. CONCLUSIONS: The results of our study and a review of the literature confirm the successful and recurrence-free treatment of DFSP with micrographic surgery as the treatment of choice for this locally invasive tumor. Particularly in recurrent lesions, we recommend the use of paraffin sectioning and three-dimensional histological evaluation as an accurate additional tool for treatment optimization.