[Teledermoscopy by mobile phones : Reliable help in the diagnosis of skin lesions?] / Teledermatoskopie mittels Smartphone : Zuverlässige Hilfe bei der Diagnostik von Hautläsionen?

BACKGROUND: Teledermoscopy is a promising modern technique to complement or to substitute dermatologic examination. OBJECTIVE: In this pilot study, we compared the outcomes of teledermoscopic consultations with clinical examinations and histologic results. METHODS: Conventional and dermatoscopic photos of single lesions were taken in 26 patients using a mobile phone and an attached handyscope optical system. Five resident physicians performed a clinical examination including dermoscopy while the teledermatologic and teledermoscopic photos were assessed by an experienced dermatologist. Examination results were compared regarding diagnosis, differential diagnoses, recommended further management, as well as subjective and objective accuracy of diagnosis. In addition, 23% of the lesions were excised and histologically examined. RESULTS: The most frequent diagnosis was "nevus cell nevus", followed by "subungual hematoma" and "basal cell carcinoma". The concordance of diagnoses was 92.3%; the concordance of recommended further management was 76.9%. Of the 6 histologically proven diagnoses, 66.7% were given the same diagnosis by teledermatoscopy and conventional clinical assessment. Concerning accuracy of diagnosis, teledermoscopy showed no disadvantage. CONCLUSIONS: Teledermatologic photos of single lesions combined with teledermatoscopic photos can be reliably and safely assessed. Especially when access to dermatologic examination is difficult, mobile teledermoscopy is a good and reliable alternative.

A new basophil activation test using CD63 and CCR3 in allergy to antibiotics.

BACKGROUND: Flow cytometric basophil activation tests (BAT) have been developed as cellular tests for in vitro diagnosis of IgE-mediated reactions. Different markers and techniques have been used after stimulation with various allergens. OBJECTIVE: It was the aim of the present study to compare an established BAT (Flow-CAST) with a newly developed basophil activation protocol using CD63 and CCR3 (Flow2 CAST) in patients with type-I allergy to antibiotics. MATERIALS AND METHODS: Twenty-four patients with a history of type-I allergy to antibiotics were examined. A careful allergy history was taken, and skin tests and determination of specific IgE antibodies were performed. Two different BAT using CD63 expression but different protocols were carried out after stimulation with different concentrations of antibiotics. Fifteen healthy subjects without a history of antibiotic allergy were studied as controls. RESULTS: The Flow2 CAST showed a higher sensitivity than the Flow-CAST (55% vs. 53%) with regard to patients' history. Specificity was 80% both for the Flow2 CAST and for the Flow-CAST with regard to controls with negative history and negative RAST. CONCLUSION: These results show the value of two different BAT as cellular tests in the in vitro diagnosis of patients with antibiotic allergy with equal specificity and a slightly higher sensitivity for the Flow2 CAST.