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Skinhealth, A Mobile Application for Supporting
Teledermatology: A Case Study in a Rural Area in
Colombia
Juan Pablo Sáenz1*, Mónica Paola Novoa2, Darío Correal1 and Bell Raj Eapen3
1 Systems and Computing Engineering Department
Universidad de los Andes, Bogotá, Colombia
2 Fundación Universitaria de Ciencias de la Salud
Hospital San José, Bogota, Colombia
3 Kaya Skin Clinic
Dubai, United Arab Emirates
* Currently, Ph.D. student at the Politecnico di Torino
6th EAI International Conference on Wireless Mobile Communication and Healthcare
14-16 November 2016, Milan, Italy

Agenda
§ Motivation
§ Teledermatology mHealth application
§ A case study in a rural area in Colombia
§ Results
§ Discussion
2

Agenda
§ Motivation
§ Results
§ Discussion
3

Motivation
§ The use of mobile health applications (or mHealth) to support
telemedicine is becoming increasingly popular
§ The ease of use and the ubiquity of mobile phones make its
use in remote diagnostic applications increasingly viable
4

Motivation
In Colombia…
§ According to the Colombian Association of Dermatology, there
were 1.25 dermatologists per 100,000 inhabitants, with a large
number of them in larger and more densely populated cities (3
per 100,000 inhabitants), thus leaving rural areas without
specialized dermatological care options
5

Context
Given this scenario, we…
§ Developed a system (Skinhealth) to support the diagnostic
process of skin lesions by integrating a dermatological
ontology and knowledge base, with a mobile application
§ Used the mobile application in a rural, geographically and
economically marginalized area, with public order issues
§ Validated and reported the results of the first-time use of
Skinhealth in a rural area in Colombia
6

Agenda
§ Motivation
§ Results
§ Discussion
7

Teledermatology mHealth application
8
Developed Android and iOS mobile applications to characterize skin
lesions

9

Birth date Adult, Child, Fetal, Infant, Neonate, Pediatric
Sex Men, Women
Phototype 1 to 6
Lession Type Atrofic, Cyst, Macule, Nodule, Patch, Plaque, Pustule, Ulcer, Vesicle
Shape Annular, Circinate, Dome, Ragged, Oval, Pendiculated, Round, Umbilicated
Number Disseminated, Multiple, Recurrent, Solitary
Distribution Assymetrical, Confluent, Scattered, Symmetrical
Affected areas Abdomen, Anogenital, Arm, Back, Buttock, Chest, Dorsal Foot, Dorsal Hand, Ear, Face, Finger,
Nail, Finger Web, Head, Leg, Neck, Palm, Scalp, Sole, Toe, Toe nail
Border Poorly demarcated, Well demarcated
Symptoms Alopecia, Blanching, Desquamation, Pain, Edema, Eruption, Excoriation, Exfoliation,
Hemorrhage, Pigmentation, Pruritus, Fever, Facial paralysis, Weight loss, Systemic symptoms
Past Anemia, Arthritis, Mal nutrition, Epileptic, Hypertension, Hypotension, Myocarditis, Neuropathy
10
Parameters to characterize skin lesions

The domain ontology: ONTODerm
§ Dermatological ontology designed to be
collaboratively developed by domain
experts in a convenient and accurate
manner without the need of technical
instructions
11
http://www.teresewinslow.com

12
Skinhealth overall perspective

Agenda
§ Motivation
§ Results
§ Discussion
13

A case study in a rural area in Colombia
§ The use of the application was made within the context of a
program called Health Brigades in Colombia. It is organized by
the foundation “Alas Para la Gente” (Wings for the People)
14

§ First phase of this study was conducted
in a Colombian municipality called Cubará
§ It has a population of 3,118 inhabitants;
1,551 women and 1,567 men, most of
them belonging to the U'wa indigenous
tribe
§ The nearest medical centre with a
dermatologist available is 166 kilometres
away in the city of Cúcuta, at an eight-
hour overland journey through a jungle
area
15

§ During the three-day brigade, a total of
65 (7.26%) dermatology consultations
were performed
§ A general physician attended
dermatological visits between 8 a.m.
and 5 p.m. Skinhealth was installed on a
tablet with version 4.2 of the Android OS
16

Agenda
§ Motivation
§ Results
§ Discussion
17

Results
§ The second phase of the study is performed once the health
brigade concludes
§ A dermatologist with broad experience in skin diseases
examines the characterization of each query and compares this
information with the diagnosis made by the general practitioner
§ The physician's diagnosis is marked accurate if it corresponded
with the dermatologist's diagnosis
§ In the case of the ontology, the set of eight differentials was
marked accurate if at least one of them is consistent with the
dermatologist's diagnosis
18

Results
§ The results showed that the probability of obtaining a correct
diagnosis was between 64.4% and 85.6% and a confidence
interval of 95%
§ The percentage of accurate queries in which the face was
identified as the affected area was 96%
19

Agenda
§ Motivation
§ Results
§ Discussion
20

Discussion
§ This study demonstrated the implementation of a different
strategy of teledermatology that relies on a mobile application
and a domain ontology, to immediately assist a general
practitioner who answers dermatological consultations
§ This approach was found relevant in the Colombian context,
particularly in geographically and economically marginalized
regions
§ Since the sample size is small, more studies would be necessary
to validate the findings
21

Thank you!
22
juan.saenz@polito.it
jp.saenz79@uniandes.edu.co

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Skinhealth, A Mobile Application for Supporting Teledermatology: A Case Study in a Rural Area in Colombia

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Skinhealth, A Mobile Application for Supporting Teledermatology: A Case Study in a Rural Area in Colombia