Mobile teledermatology in the developing world: Implications of a feasibility study on 30 Egyptian patients with common skin diseases Kathleen Tran, MD, MSc, a Mohamed Ayad, MBBCh, DipHM, b Jennifer Weinberg, BS, c Augustin Cherng, BS, d Mridul Chowdhury, MPA, e Saadeddin Monir, MBBCh, MSc, b Mohamed El Hariri, MBBCh, MSc, b and Carrie Kovarik, MD f New York, New York; Cairo, Egypt; Philadelphia, Pennsylvania; London, United Kingdom; and Boston, Massachusetts Background: The expansion of store-and-forward teledermatology into underserved regions of the world has long been hampered by the requirement for computers with Internet connectivity. To our knowledge, this study is one of the first to demonstrate the feasibility of teledermatology using newer-generation mobile telephones with specialized software and wireless connectivity to overcome this requirement in a developing country. Objective: We sought to demonstrate that mobile telephones may be used on the African continent to submit both patient history and clinical photographs wirelessly to remote expert dermatologists, and to assess whether these data are diagnostically reliable. Methods: Thirty patients with common skin diseases in Cairo, Egypt, were given a diagnosis by face-to- face consultation. They were then given a diagnosis independently by local senior dermatologists using teleconsultation with a software-enabled mobile telephone containing a 5-megapixel camera. Diagnostic concordance rates between face-to-face and teleconsultation were tabulated. Results: Diagnostic agreement between face-to-face consultation and the two local senior dermatologists performing independent evaluation by teleconsultation was achieved in 23 of 30 (77%) and in 22 of 30 (73%) cases, respectively, with a global mean of 75%. Limitations: Limited sample size and interobserver variability are limitations. Conclusion: Mobile teledermatology is a technically feasible and diagnostically reliable method of amplifying access to dermatologic expertise in poorer regions of the globe where access to computers with Internet connectivity is unreliable or insufficient. ( J Am Acad Dermatol 2011;64:302-9.) Key words: global health; mobile teledermatology. T eledermatology, or the use of modern tele- communications technology to provide der- matologic care from a distance, has become an increasingly important and impacting subject of study in recent years. Multiple authors have eluci- dated the potential of teledermatology as a diagnosis From the Memorial Sloan-Kettering Cancer Center, New York a ; Department of Dermatology, Venereology, and Andrology, Al- Azhar University, Cairo b ; University of Pennsylvania School of Medicine c ; Development Fund and Accenture Development Partnerships, London d ; Click Diagnostics, Boston e ; and Depart- ment of Dermatology, University of Pennsylvania. f Development of ClickDoc’s teledermatology function was sup- ported by the GSM (Global Systems for Mobile Communica- tions) Association’s Development Fund and Qualcomm’s Wireless Reach initiative. Disclosure: ClickDoc, used in this study, was developed by the United Statesebased mobile telemedicine company ClickDiag- nostics. Mr Chowdhury is Chief Executive Officer and Co-Founder of ClickDiagnostics. Dr Ayad is a consultant for ClickDiagnostics. Drs Tran and Kovarik, Ms Weinberg, Mr Cherng, Dr Monir, and Dr El Hariri have no conflicts of interest to declare. Accepted for publication January 5, 2010. Reprint requests: Carrie Kovarik, MD, Dermatology, Dermatopathology, and Infectious Diseases, University of Pennsylvania, 2 Maloney Bldg, 3600 Spruce St, Philadelphia, PA 19104. E-mail: carrie.kovarik@uphs.upenn.edu. Published online November 22, 2010. 0190-9622/$36.00 ª 2010 by the American Academy of Dermatology, Inc. doi:10.1016/j.jaad.2010.01.010 302