Remote Photo Assessments of AD Severity Comparable to Office-Based Assessments

Remote atopic dermatitis severity assessments using photos are strongly associated with in-person assessments, suggests a proof-of-concept study published online in the journal JMIR Formative Research. 

“Digital imaging of dermatological patients is a novel approach to remote assessment,” wrote researchers from Denmark, “and has recently become more relevant since telehealth and remote decentralized clinical trials are gaining ground.” 

The study included assessments of atopic dermatitis severity during in-person visits with an investigating doctor, who also took photographs of lesions with a smartphone and a digital single-lens reflex (DSLR) camera. Five dermatologists then assessed the photos using the intensity items of the SCORAD index (iSCORAD), which spans erythema, edema/papulation, excoriations, lichenification, oozing/crusts, and dryness.  

The study compared the average iSCORAD for photographs with in-person assessments for 942 photographs of 170 lesions from 95 patients. 

Severity assessments based on smartphone photos correlated strongly with in-person evaluations, according to the study. One analysis showed an average score difference of 1.31 between in-person and remote iSCORAD. Interrater agreement among the five rating dermatologists was 0.93.  

The difference in mean scores between in-person and remote evaluations based on photos taken by a DSLR camera was 1.32, researchers reported. Average score differences between in-person evaluations and those based on photos taken by a smartphones were 1.13 when no flash was used and 1.43 when a flash was used. 

“In terms of quality, remote atopic dermatitis severity assessments based on photographs are comparable to in-person assessments, and smartphone photos can be used to assess atopic dermatitis severity to a similar degree as photographs from a DSLR camera,” researchers concluded. “Further, the variation in how the dermatologists in this study rated the iSCORAD based on the photographs was very low.” 

Reference:
Ali Z, Joergensen KM, Andersen AD, et al. Remote Rating of Atopic Dermatitis Severity Using Photo-Based Assessments: Proof-of-Concept and Reliability Evaluation. JMIR Form Res. 2021;5(5):e24766. Published 2021 May 25. doi:10.2196/24766