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Opportunities, risks seen with dermatology apps

By Genevra Pittman

NEW YORK (Reuters Health) - Mobile dermatology applications may help people learn about UV rays or keep tabs on their moles, but they are not a substitute for seeing a doctor, researchers said Wednesday.

They searched online stores and found over 200 dermatology apps, half of them made for non-doctors. Those included sunscreen recommendation guides, mole photo storage apps and tools meant to help diagnose melanoma.

"I am very hopeful that these applications will increase access to medical knowledge," Dr. Robert Dellavalle, a dermatologist at the University of Colorado School of Medicine in Aurora, said.

However, "The biggest concerns are people getting the wrong information," Dellavalle, the study's senior author, told Reuters Health. Only a few of the apps were clearly made by medical professionals, the researchers noted.

The study follows an announcement by the U.S. Food and Drug Administration on Monday that it will regulate a subset of medical apps intended for doctors.

Those include apps that can "be used as an accessory to a regulated medical device," such as one that would allow a doctor to make a diagnosis based on a photo sent via the app.

For their study, Dellavalle and his colleagues searched the Apple, Android, BlackBerry, Nokia and Windows app stores for products related to dermatology. They found 209 apps, including 10 with at least 35 reviews at the time.

The most frequently reviewed apps made for the general public included Ultraviolet ~ UV Index (http://bit.ly/14S9caG), SPF (http://bit.ly/16r6HBY), iSore (http://bit.ly/18pY0nh) and SpotMole (http://bit.ly/18pMavp).

Of those, Ultraviolet ~ UV Index currently has the highest reviewer ranking at between 4 and 5 on a 5-star scale. The app shows the UV index for the user's current location.

SPF calculates how much time a user can be in the sun based on skin type and UV index, and iSore has a directory of skin conditions with a "graphic picture" and treatment information. SpotMole is designed to check photos of moles for signs of cancer.

About half of the apps were free. The rest cost an average of $2.99, the researchers reported Wednesday in JAMA Dermatology.

They said both patients and doctors should "maintain a healthy sense of skepticism" when it comes to using dermatology apps. That is especially true for apps that claim to help spot conditions such as skin cancer and could delay a real diagnosis.

For instance, a recent review of smartphone apps that use algorithms to analyze skin lesions found they weren't always good at predicting which ones were cancerous (see Reuters Health story of January 16, 2013 here: http://reut.rs/13EoYqz).

IMPROVING PATIENT ACCESS

Some of the most promising apps are ones that connect patients in remote areas to dermatologists, such as through video chats, Dr. Karen Edison, a dermatologist from the University of Missouri in Columbia, said.

The researchers found eight of those so-called teledermatology apps.

Dermatologists are in short supply in many parts of the country, Edison, who wasn't involved in the new research, said.

"I think it's time to use technology to make us more available," she told Reuters Health.

"I support the use of technology in getting access to dermatology expertise for patients who would not otherwise have access to that expertise as well as for convenience for patients … if it can be done in a high-quality way that takes patient safety into account."

She said it's important for doctors evaluating remote patients to know if they have access to medication or can see a dermatologist in person to do a biopsy, if necessary. That means an app that relies just on sending pictures and diagnoses back and forth, for instance, isn't likely to be very helpful, Edison said.

Dellavalle said the world of dermatology apps is currently a "buyer-beware atmosphere."

He recommended patients cross-reference information they get from apps with other resources and talk with their doctor before making any treatment decisions based on apps.

SOURCE: http://bit.ly/1fnGfMW JAMA Dermatology, online September 25, 2013.

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