Our Services A - Z - Teledermatology
About the service
Teledermatology
Mersey and West Lancashire Teaching Hospitals NHS Trust are working in partnership with Skin Analytics, an external provider who will support the assessment of your skin lesion using an artificial intelligence computer programme called DERM. The service is across two sites within the Mersey West Lancashire NHS Trust area locality. One site is held in the Southport hospital whilst the second is held in the St Helens hospital. G.P.s’ will refer their patients to the most appropriate location to have their lesion assessed.
Teledermatology involves a suitably qualified professional Health Worker taking a series of digital photographs of a patient’s skin lesion within the Teledermatology clinic. If the lesion is suitable, the photographs are then sent to Skin Analytics for assessment by DERM. The assessment of clinical diagnosis by DERM is with considerable success in determining if the lesion is cancerous or not. The photographs will be reviewed by a Dermatologist who will decide if the patient needs to come into hospital for a focused review or treatment, or can be discharged back to their G.P.
- The Process
Patients attending their G.P. surgery may be referred to the Dermatology pathway in the case of them having a suspicious lesion that the G.P. would like to be assessed. The G.P.’s referral is reviewed to see if it is suitable for a Teledermatology appointment and having the lesion photographed. Please Note: Only the lesion that has been specified by the referring G.P. in the referral form will be photographed during an appointment.
If selected to have a Teledermatology appointment, the Patient will receive a pre-appointment questionnaire from Skin Analytics which is ideally completed prior to the appointment date. The questionnaire is a brief set of questions regarding general health and information the dermatologist would require determining how best to assess the patient. The Patient will also be asked if they consent to the process for the photography & A.I. assessment of their lesion. The Patient would need to provide their consent for the Teledermatology appointment to go ahead. If the Patient decides not to provide consent for Teledermatology then it will just means that they would necessitate scheduling to attend a consultant face to face appointment for the lesion’s assessment.
Further consent is optional for the use of the patient’s data by both Skin Analytics and Mersey West Lancashire Teaching Hospitals for teaching and research purposes. The non-consent for this activity with the patient’s data would not impact on the A.I. assessment of any photographs consented to.
In the Teledermatology appointment, photographs of the lesion will be taken with a Dermatoscope. These images magnify the skin lesion and allows its inspection without skin surface light reflections. The dermatoscopic images will be assessed by the Skin Analytics A.I. software called DERM, and a determination of what type of lesion would be signified. The Patient and their G.P. will then be notified of any necessary steps further to be taken or if no action is required.
Any patient who hasn’t been put on the Teledermatology pathway would still be seen by a dermatologist consultant to have their suspicious lesion examined.
- In Conclusion
Once a Patient has had their photographs taken and they have been submitted to the Skin Analytics platform, DERM will assess the images and detail it’s findings. From these findings, the Patient’s next steps will be determined.
If the lesion has been assessed as being benign and no further action is required, then the referral will be closed and the Patient discharged back to their G.P.
The Patient & G.P. will be advised and notified of the outcome of the examination result by letter, informing them that there is no further action required from the hospital unless there is a future change in the lesion’s condition.
If the lesion has been assessed by DERM that it needs further reviewing, then a Dermatologist is notified to review the image which could also possibly incorporate a further appointment to see the Dermatologist face-to-face to physically check out the lesion on the Patient. This is to enable a formal diagnosis of the suspect lesion type and to determine the Patient’s next actions or a treatment.
Patients will be contacted after their Tele-dermatology appointment within a maximum of ten working days to advise if they need to come into hospital for further review.
*A request to attend a face-to-face review does not conclude that the suspicious lesion is cancerous. It just indicates that the A.I. was unable to make a conclusive determination of the image and the dermatologist will make a physical assessment to clarify just what the lesion may be.
If you are concerned about any lesions or skin problems, please seek advice from your G.P. in the first instance.
- British Association of Dermatology
- MWL Teledermatology Patient Information Leaflet
- Skin Analytics A.I. Path
- Skin Analytics & Derm
- Skin Analytics Privacy Policy
- NHS Live Well - Seasonal Health
Teledermatology Pathway – Patient Experience Questionnaire
The Teledermatology pathway was set up to help improve cancer performance and wait times for our patients.
We would be grateful if you could complete the following questionnaire to support the Trust review and improve the service and patient experience.
The questionnaire should take about 5 minutes to complete. This patient questionnaire is anonymous will not affect your care and your feedback is extremely appreciated.
Teledermatology FAQs
Please refer to our frequentlyasked questions below:
- What is teledermatology?
Teledermatology involves referring an image of the skin lesion of a patient together with relevant history of the condition to be photographed for further review. A suitably qualified Health professional will take a series of digital photographs of the lesion. These photographs will be sent to an Artificial Intelligence (A.I.) software company for digital assessment to see if you would need to come into hospital for further review or treatment.
They will photograph a general view of the area of interest to establish the location of your lesion, and a detailed close up using a specialised lens called a dermatoscope. The dermatoscope allows the photographer to capture highly detailed images of your lesion, by pressing gently against the surface of the skin. This should not hurt.
The photographer would be using two devices in combination to take the photographs:
- A camera phone, and
- A DL1 Dermatoscope
It may not be possible to photograph some lesions using the dermatoscope. This will be explained to you at your appointment. In these cases, you will be referred directly for a face-to-face appointment.
- How it begins
A Patient would be referred by their GP to Mersey West Lancs NHS Trust; and an appointment made for photographs to be taken at either Southport Hospital or St Helens Hospital. Please note: only lesions that are documented by the G.P. on the referral can be photographed during the appointment.
The Patient would receive a telephone call to have an appointment arranged to whichever pathway is suitable based upon the G.P. referral. There are several exclusion selection criteria for lesions that are unsuitable for the Teledermatology pathway. The alternative pathway is a face-to-face appointment with a dermatologist consultant.
- Why Teledermatology?
With the advances in computer technology and software, it has enabled the use of Artificial Intelligence to assist the Dermatologists to concentrate on more focused interventions on individuals. Teledermatology along with the assistance of the A.I. software means that a suspicious lesion can be automatically identified quicker. It will relieve individuals earlier if the lesion is non-cancerous, or if it is questionable as to a potential concern, then the earlier determination & action can resolve anxiety for the individual with a quicker assessment & treatment.
The process will allow the Dermatologists to maximise the opportunity to seeing those patients who need their diagnosis of any potential concern sooner, with quicker treatment pathways to provide reassurance & positive outcomes.
- The Pre-Appointment Questionnaire
As part of arranging an appointment to the Teledermatology pathway, a Patient will be provided with a questionnaire link to complete prior to their appointment. This is to collect some general health questions of the patient and to have their Consent agreement to have photographs taken and them being used by the A.I. software. A consensual agreement by the Patient is required for the pathway.
There is also a consent request for a Patient data being used by Skin Analytics to assess for future improvements to the A.I. software. This is optional.
A review of the questionnaire answers will be undertaken in your appointment, and further details of the lesion will be collated to ensure all relevant information is available for a dermatologist if a further review is required.
- After The Photographs – What Next?
Once the photography is complete, the images will be securely uploaded to Skin Analytics, where they will then be assessed by the DERM software. The resultant determination of the DERM assessment would indicate whether the Patient can be discharged or whether further review could be required by a Dermatologist.
If the assessment concludes that the Patient does not need a further assessment, then the referring G.P. will be informed of the resultant action to discharge the Patient for no further action to be undertaken by the hospital.
- Further Review?
If the DERM result requires a further review by a Dermatologist, then a secondary hospital appointment would be required. The hospital administration team to contact the patient to arrange an appointment in a dermatology clinic for a face-to-face review. Their assessment may conclude with the options to take a small skin sample (biopsy), or to arrange to have the removal of the lesion).
- How Long Will My Appointment Take & What Will Happen?
A normal appointment should last around 15 minutes if the pre-appointment questionnaire is completed prior to the appointment time and the patient arrives in good time to be seen.
Please note: A patient may be asked to remove jewellery or make up where necessary. Depending on the location of the lesion, the patient may also be asked to remove articles of clothing to gain a better view of the area of interest. If you are required to remove clothing, it may require a chaperone to be present in the room with you for support & re-assurance.
- Do I Need To Give Permission For Photographs To Be Taken?
Yes, consent to having photographs taken and for the non-human DERM software to assess the images needs to be consented to by the patient to progress on the Teledermatology pathway.
This is to ensure that the patient is comfortable with the photographs being taken and how the clinical images would be used. If you are happy to proceed, you will be required to provide verbal confirmation of your consent, which will be recorded on your referral form.
We will not take any photographs without your permission.
A further optional consent for the future use of the image by Skin Analytics to improve their software responses is requested, but this doesn’t prohibit the photographs or use of the DERM A.I.
You may withdraw your consent at any time by contacting the Hospital Dermatology department. Clinical photographs that have been used to make a clinical decision cannot be deleted, however your images can be retracted and hidden from view on your electronic patient record.
Retracting consent will not affect your treatment or any future treatment you may receive.
- How Is My Data Used By Skin Analytics?
To process your assessment, Skin Analytics will securely store your medical referral and images, together with standard identification information necessary for the safe and accurate filing of the assessment report (i.e. your name, date of birth and NHS number).
The assessment report will be available for MWL Trust to use appropriately in support of any further care or treatment you may need. The results of the assessment will be sent to your G.P. practice to be included in your medical records.
More information on how the Trust processes your data can be found on the Trust website.
- Does A Further Review Appointment Or Surgery Mean I Have Cancer?
No. You could be asked to come back for several reasons by the Dermatologist. Appointments will generally be seen within a few weeks, so there should not be a long wait.
- What Are The Exception Criteria?
Presently there are exception criteria in which the A.I. software is unable to establish a result outcome. These prevent a Patient going onto the Teledermatology pathway and would necessitate a face-to-face appointment with a Dermatologist. These criteria are:-
- Patient must be 18+ (Any patient under this age is not suitable for the Teledermatology pathway).
- Intimate areas of the body would require a face-to-face appointment with a Dermatologist.
- Any lesion larger than 20 mm in diameter/length. [This is the size of the lens of the Dermatoscope used to capture the image].
- The lesion is open & weeping or is ulcerated.
- The lesion is covered heavily by hair or is located on tattoo or scar tissue.
- The lesion is underneath nails, or in the eye area or mucosal surfaces [mucous bearing skin surfaces].
- The lesion is situated on the Palm of a hand, or the Sole of a foot.
- A previous lesion that is previously reviewed and monitored by a Dermatologist.
- Any concerns where the lesion is not suspected to be potential Skin Cancer, [Rashes, Eczema, etc…]
- The lesion has had previous Biopsy/Surgery undertaken at the lesion location.
- When Should You Worry About A Mole/Lesion On Your Skin?
It is important to check your skin regularly for any change. You may want to ask a family member or a friend to examine your back.
Following the ABCDE – easy rules can help you identify potentially worrying features:
- Asymmetry – the two halves of the lesion may differ in shape
- Border – edges of the lesion may be irregular, blurred or notched
- Colour – the colour may be uneven
- Diameter – report any mole larger than 6mm or a change in size or shape
- Evolution – changes in size, shape, colour or elevation or any new symptom such as bleeding, itching or crusting
It can be helpful to take images of your lesion to see if the lesion is changing over time as it can be more reliable than using memory alone. It can be useful to do this every few months using a phone with a camera.
If you notice any of the changes described above or are concerned about a mole or patch of skin for any other reason, then contact your G.P. as soon as possible.
- How Can You Reduce Your Risk Of Skin Cancer?
It is recognised that unprotected exposure to UV radiation can increase your risk of skin cancer. It is therefore important to be careful in the sun.
The British Association of Dermatologists (BAD) have compiled the following ‘Top Sun Safety Tips’:
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Protect your skin with adequate clothing, wear a hat that protects your face, neck and ears, and a pair of UV protective sunglasses
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Choose sun protective clothing (with permanently sun-protective fabric, widely available for adults and children) if you have fair skin or many moles
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Spend time in the shade between 11:00am to 3:00pm when it’s sunny
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Step out of the sun before your skin has a chance to redden or burn
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When choosing a sunscreen look for a high protection SPF (current recommendations are SPR 50 or 50+) to protect against UVB, and the UVA circle logo and/or 4 or 5 UVA stars to protect against UVA
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Apply plenty of sunscreen 15 to 30 minutes before going out in the sun, and reapply every two hours and straight after swimming and towel-drying
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Keep babies and young children out of direct sunlight
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Sunscreens are not an alternative to clothing and shade, rather they offer additional protection (no sunscreen will provide 100% protection)
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Do not use sunbeds
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Page last updated on 14th February 2025