Diagnostic reliability of three telecytological methods in dermatological diseases

Cytology is a simple, rapid, inexpensive and repeatable method for the diagnosis of various erosive-vesiculobullous, tumoral and granulomatous diseases. However, the cytological evaluation of all dermatological diseases requires more experience. Today's technological advances make it possible to transfer cytological images from one site to another, and thus distant experienced observers can evaluate these images. These processes are referred to as telecytology. Although there are a small number of telecytological studies about other system diseases reported in literature, no telecytological studies on dermatological diseases have been reported to date. This study aims to evaluate the diagnostic reliability of three telecytological methods in dermatological diseases. Patients evaluated using Tzanck smear test at Başkent University Faculty of Medicine, Department of Dermatology, between July 2012 and March 2013, were included. The cytological materials were evaluated by four dermatologists. Dermatologist A took the Tzanck smear material and made a final diagnosis with clinical, cytological and laboratory findings. The cytological materials were evaluated using telecytological image transfer methods; static, videomicroscopy and dynamic systems by Dermatologists B, C and D respectively. Agreement among diagnoses made by Dermatologist B, C and D were determined by comparing with the final diagnosis. A total of 84 (44 [52.4%] male and 40 [47.6%] female) patients were included in this study. In 84 patients, 49 (58.3%) infectious diseases, 31 (36.9%) tumoral diseases, 3 (3.6%) spongiotic dermatitis and 1 (1.2%) genodermatosis were diagnosed. The diagnostic reliability of all of the three telecytological methods were almost perfect for all types of lesions. However, the diagnostic reliability of dynamic telecytological method on tumoral lesions was almost perfect while that of other methods were substantial. The results of our study revealed that all of the three telecytological methods are reliable in the diagnosis of dermatological diseases; whereas the dynamic system is the most reliable one in tumoral diseases. Keywords: Cytology, telemedicine, telecytology, Tzanck smear.