Mobile “apps” in Dermatology

What “apps” are available and do they work ?

• At the time of this presentation about 1 million apps are available app store 50 billion downloads
• 17000 apps are health-related – evidence about their reliability is mostly lacking. They are projected to generate $26 billion revenue in 2017
• In 33% physicians are NOT involved in their development
• apps are not quality checked before being made available (except for language, profanity etc…)
• At the time of publication there are 250 dermatology apps, half of them are linked to skin cancer

Utility of apps: people nowadays want more autonomy and no not necessarily want to consult a dermatologist if not necessary. In general people who die of melanoma are the ones who don’t see a dermatologist (because the lesions grow unchecked).

Available apps

• information apps: how UV acts on the skin, how to use a sunscreen. ABCD rule…
• autodetection apps (detection): automatic detection of lesions (Melapp…)
• follow-up apps: UMskincheck…
• teleconsult apps (idoc24, cellscope, spruce): picture sent to the dermatologist who makes the diagnosis

Autodetection apps do not really work:

• Overall up to 33% of melanomas missed are.
• low specificity and sensitivity.
• The Exception are teledermatology apps (picture sent to the dermatologist who makes the diagnosis)source: retropsective study by Wolff JA et al. (JAMA dermatol. 2013

How should they work ?

• They should not miss a melanoma: difficult because even dermatologists can miss them
• Only use informative apps and avoid automated diagnosis apps ?

Sometimes pictures are not perfect (blurry) and the question is how research (real-time) can be done to improve the apps

Conclusion: overall not enough for now (at the time of publication)

What does the future hold ?

-watches

-glasses

-apple (epic)

-google health (discontinued)

-facebook has health plans

-total body gigapixel camera

Contributors

Dr Christophe Hsu – dermatologist. Geneva, Switzerland

Source of information: 2014 (10) – Bekkenk M. EADV Annual Meeting, Amsterdam The Netherlands