Remote diagnosis using three-dimensional total-body photography (3D-TBP) enabled dermatologists to correctly identify common skin diseases in approximately 85% of cases, supporting 3D-TBP as a promising tool for extending dermatologic care beyond traditional telemedicine approaches. These study results were published in the Journal of the American Academy of Dermatology.

As the global need for dermatologic services increasingly exceeds provider capacity, conventional photo-based teledermatology remains limited by inconsistent image quality and varying patient digital skills. In contrast, 3D-TBP captures 92 synchronized images to generate a 3D model in seconds and has already proven valuable in skin cancer diagnosis. However, its effectiveness in diagnosing general dermatologic conditions had not been previously evaluated.

In this single-center observer-agreement study, 294 adults with visible skin changes underwent a 3D full body scan alongside routine face-to-face examinations between January and September 2023. After excluding patients with incomplete data, 283 patients were retained. The 3D images were then independently reviewed by 2 experienced board-certified dermatologists who were blinded to clinical information. The dermatologists recorded their diagnoses and management decisions. Diagnostic accuracy of the 3D images was compared with in-person evaluations and categorized into 5 disease groups. Patient experiences were assessed via questionnaire, and statistical testing used Chi-squared and Fisher exact tests.

A diagnosis was established in 263 patients, as some scans were partially uninterpretable due to limited visibility of areas like the scalp, nails, and mucosa. The first dermatologist reached 81.1% diagnostic agreement of 3D-TBP with the gold standard, while the other achieved 68.4% diagnostic agreement. The diagnostic accuracy rose to 86.7% when utilizing either dermatologists’ assessment. When grouping conditions into broader categories, accuracy improved further at rates of  84.0% (Cohen’s κ =.7) and 73.8% (Cohen’s κ =.5) for the 2 dermatologists, respectively. The greatest accuracy was seen for inflammatory diseases and the lowest accuracy was seen for reactive diseases. High concordance was observed for common disorders such as atopic eczema (92.3% and 80.8%), psoriasis (91.7% and 77.8%), and vitiligo (93.3% and 100%).

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[O]ur study proves the feasibility of diagnosing general skin diseases with tele 3D-TBP including a high physicians’ and patients’ acceptance.

Patients responded positively to 3D-TBP, as most reported the process as comfortable (mean 1.5 on a 6-point Likert scale) and potentially beneficial to care (mean 1.9). Top strengths cited included scan speed (82.03%) and modernity (73.56%), while concerns centered on privacy (51.53%) and feeling shame during the scan (6.44%). One-third of patients (33.9%) said they would be willing to pay for the service, with a mean price of €62.

Limitations of the study include the exclusion of non-ambulatory patients and possible selection bias toward those comfortable with new technology. Not all diagnoses were histologically confirmed, and certain anatomical areas were difficult to assess due to image artefacts which potentially leads to underestimation of the tool’s true diagnostic potential.

“[O]ur study proves the feasibility of diagnosing general skin diseases with tele 3D-TBP including a high physicians’ and patients’ acceptance,” noted the authors. They added, “Further studies are needed to delineate its role in future dermatology health care with a diminishing number of dermatologists.”

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