Almazan-Delgado, E (E);Medina-Cobos, A (A);Cebolla-Verdugo, M (M);Garzón-Aguilar, J (J);Llamas-Segura, C (C);Ruiz-Villaverde, R (R);

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Semergen.2025 May 08;51(6):102504.doi:10.1016/j.semerg.2025.102504

Abstract

INTRODUCTION: Daylight photodynamic therapy (DL-PDT) is an established option for the treatment of actinic keratoses (AK). In this context, teledermatology has emerged as a promising tool for the follow-up of dermatological patients. This study evaluates the concordance between in-person and teledermatological assessments in the management of AK using DL-PDT.

MATERIAL AND METHODS: A prospective observational pilot study was conducted on 12 patients treated with DL-PDT. In-person and telematic evaluations were compared regarding the number and severity of lesions, pain, inflammation, efficacy, and cosmetic outcomes. Pearson's correlation coefficients and Cohen's kappa index were used to measure concordance.

RESULTS AND DISCUSSION: The study population consisted predominantly of men (91.7%) with a mean age of 73.9 years. Lesions were located on the scalp (66.7%) and cheeks (33.3%). In-person and teledermatological assessments showed highly similar results for the number of grade I and II lesions (4.4 vs. 4.3 and 1.9 vs. 2.0, respectively). Pain and inflammation, evaluated using the Visual Analog Scale (VAS), were minimal during and after treatment (maximum 1.2±0.5 points). The cosmetic outcome was excellent, with a mean score of 9.2±0.9. The concordance between both assessment modalities was perfect (Pearson's correlation coefficient and Cohen's kappa index of 1.000).

CONCLUSIONS: Teledermatology is a reliable tool for the follow-up of AK treated with DL-PDT, demonstrating results equivalent to in-person evaluation. This supports its implementation in clinical practice, particularly in cases where in-person access is limited.