The Teledermatology department are working with GP surgeries to help assess skin lesions through a clinic run by University Hospitals Birmingham NHS Foundation Trust (UHB) and Skin Analytics. This means you do not need a GP appointment in order to have your skin lesion assessed and can be seen directly at a diagnostic hub.
At the Teledermatology clinic, a qualified clinical photographer will ask you a series of questions about your medical history and skin lesion before taking some digital photographs.
The clinic is run in partnership with Skin Analytics, an external company who will support the assessment of your skin lesion using DERM, a specially developed computer program. DERM has been developed by Skin Analytics to recognise skin cancer and common harmless skin conditions using photographic images. A consultant dermatologist will also review all images to determine whether any treatment is required.
You will not have a face-to-face consultation with a doctor at this appointment. If you do not give your consent to proceed with the use of the Skin Analytics platform at your appointment, we will discharge you back to your GP. If you are still concerned about your lesion, please contact your GP.
Only the lesion(s) that have been specified following your conversation with your GP surgery receptionist will be photographed during your appointment.
Once photography is complete, your images will be securely saved and uploaded to your Electronic Patient Record (EPR).
Frequently asked questions
What is the Teledermatology service?
The Teledermatology service is being provided at local hubs where a qualified professional clinical photographer will take a series of digital photographs of your skin lesion. These photographs will be sent to a dermatologist for remote assessment to see if you need to come into hospital for further treatment. You will not have a face-to-face consultation with a doctor at this appointment.
Clinics run in partnership with Skin Analytics, an external company who will support the assessment of your skin lesions using a specially developed artificial intelligence computer program called DERM. DERM has been developed by Skin Analytics to recognise skin cancer and common harmless skin conditions using photographic images.
What is DERM?
DERM is a medical device, that uses artificial intelligence to identify skin cancer.
DERM will analyse a dermoscopic image of a skin lesion. Dermoscopic images are images taken with a dermatoscope, which magnifies the skin lesion and allows its inspection without skin surface light reflections. Once the image has been reviewed, you will receive a letter to let you know if you require a face to face appointment with a clinician or any treatment.
During a telephone call with a receptionist at your GP surgery, you were asked a series of questions to determine your suitability to attend a diagnostic hub, your GP receptionist has confirmed you met the criteria and has requested an appointment for you to be seen. The Clinical Photographers will take images of the lesions that you described to your GP receptionist. This will have been explained to you when you spoke to your GP receptionist. If you have more than two lesions, contact the booking team to cancel your appointment. You will then need to request an appointment to see your GP.
The photographer may use two different devices:
- A camera phone which uses artificial intelligence (DERM) to analyse the lesion to see if you need to see a dermatologist, and
- A professional digital camera
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.
It may not be possible to photograph some lesions using the dermatoscope. This will be explained to you at your appointment.
Once the photography is complete, your images will be securely saved and uploaded to your electronic patient record. Images taken on the Skin Analytics device will be encrypted and electronically transferred, by secure means, so they can be analysed by DERM. The software will then provide a recommendation on whether or not the lesion needs to be seen by a dermatologist at University Hospitals Birmingham NHS Foundation Trust (UHB). The Dermatology team will assess the report and review your clinical photographs. They will then contact you, usually within 21 working days, to advise if you need to come into hospital for further treatment. Patients who do not require onward referral to the hospital can be assured that their photographs will be reviewed by a consultant dermatologist to confirm the outcome of DERM.
If you are concerned about any other lesions or skin problems, please seek advice from your GP.
Some lesions will not be suitable for assessment by the Skin Analytics technology called DERM. If any of the following apply to you, please contact your GP.
- Your lesion is open and needs dressing by a health professional
- Your lesion is on your genitals
- Your lesion(s) cannot be clearly seen and photographed
- You have more than two lesions
- You require support with mobilising independently or using the toilet
On the day of the clinic, the clinical photographer will identify any lesion which should be excluded from DERM analysis.
How long will my appointment take and what will happen?
You will be asked a series of questions detailing your medical history and specific details of the lesion itself. The photographer will explain what photographs need to be taken to assess your lesion before they proceed. If you have any questions about the photography, please do not hesitate to ask.
Please note you may be asked to remove jewellery or make up where necessary. Depending on the location of your lesion, you 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 to show a sensitive area of your body, you may request a chaperone. This whole process will take approximately 15 minutes.
More information on what to expect during your visit can be found on the appointments page.
Do I need to give permission for photographs to be taken?
The clinical photographer will discuss consent with you in detail to ensure you are comfortable with the photographs being taken and how your clinical images will be used. If you are happy to proceed, you will be required to provide:
- written consent for clinical photography, and
- verbal confirmation of your consent for the Skin Analytics website, and for what is called “automated data processing”
We will not take any photographs without your permission.
You may withdraw your consent at any time by contacting the Clinical Photography 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.
As DERM makes a decision to refer your case to UHB without additional human review, you are required under GDPR to consent to what is called “Automated Data Processing”, which is where a decision is made about you without human intervention. Any decision to discharge you from the pathway without further treatment would be made by a consultant dermatologist working with Skin Analytics. If you aren’t happy to consent to this automated data processing then you wouldn’t be able to proceed and you would need to book an appointment with your GP instead. Please feel reassured that any decision related to any treatment required will always be made by a clinician.
Any photographs you have previously authorised for open publication may not be able to be withdrawn from publications already in the public domain.
How is my data used by Skin Analytics?
To process your assessment, Skin Analytics securely store your medical history data 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 UHB clinicians to view. This will support any treatment or care you may need.
The results will be sent to your GP practice within two weeks to be included in your medical records.
The assessment may be reviewed for quality assurance purposes by Skin Analytics or other authorised bodies. This data may include information collected during the assessment and any subsequent diagnoses relating to the lesions assessed.
Skin Analytics ask for your consent to use your data to improve their service. Where data relating to your assessment is used for research purposes, it will be pseudonymised or anonymised where possible. Pseudonymisation means processing your data to prevent you being identified. For example, pseudonymised data may mean names are often replaced with reference numbers so the person cannot be identified. Such additional information will be kept carefully separate from personal data.
More information on the Skin Analytics privacy policy can be found on their website.
What happens after my photographs have been reviewed?
After your photographs have been reviewed, you and your GP will receive a letter to advise on next steps. You may be:
- Discharged back to your GP
- Invited for treatment or a further review with your GP
- Invited for treatment or a further review with a UHB Dermatologist
How will I find out the result of this photographic procedure?
You should receive a letter in the post within two to three weeks or a telephone call.
If you have not heard from the team, or are concerned about changes in your lesion, please contact them.
If an outcome cannot be determined we may arrange to:
- book a biopsy (skin sample) or the removal of the skin lesion
- book a priority face-to-face clinical appointment with a dermatologist in hospital
- have a virtual video or telephone consultation
If there is no indication of anything serious, you may be offered reassurance by a clinical letter with no follow up appointment required and you will be discharged.
If you require non-urgent treatment, the Dermatology team may contact your GP to arrange treatment for you.
If, on review of your lesion, it is determined that this can be managed by your GP, you may be offered reassurance:
- by a clinical letter asking you to make an appointment with your GP
- your GP will also receive a letter confirming the findings of the images taken at the diagnostic hub
How do I contact the team?
For queries relating to booking, rearranging or cancelling your appointment or your appointment details, please contact the bookings coordinator.
For queries relating to the service or anything else, please contact the Dermatology Community Diagnostic Hub.
Does an urgent follow up appointment or surgery mean I have cancer?
No. You could be asked to come back urgently for a number of reasons. Urgent appointments will generally be seen within a few weeks, so there should not be a long wait.
Can I have copies of the photographs?
Yes. You can do this by sending a request to the Access to Health Records department. You will be required to provide your:
- name
- date of birth
- hospital registration number (if known)
- hospital where you are being treated
Full details are available on the access to health records page.
When should you worry about a mole?
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 GP 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’:
- Protect your skin with adequate clothing, wear a hat that protects your face, neck and ears, and a pair of UV protective sunglasses
- Choose sun protective clothing (with permanently sun-protective fabric, widely available for adults and children) if you have fair skin or many moles
- Spend time in the shade between 11:00 – 15:00 when it’s sunny
- Step out of the sun before your skin has a chance to redden or burn
- 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
- Apply plenty of sunscreen 15 – 30 minutes before going out in the sun, and reapply every two hours and straight after swimming and towel-drying
- Keep babies and young children out of direct sunlight
- Sunscreens are not an alternative to clothing and shade, rather they offer additional protection (no sunscreen will provide 100% protection)
- Do not use sunbeds
Last reviewed: 13 March 2023
