Elisabeth Wurm

University of Queensland, Brisbane, Queensland, Australia

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Publications (12)14.82 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: We evaluated the accuracy of diagnoses made from pictures taken with the built-in cameras of mobile phones in a 'real-life' clinical setting. A total of 263 patients took part, who photographed their own lesions where possible, and provided clinical information via a questionnaire. After the teledermatology procedure, each patient was examined face-to-face and a gold standard diagnosis was made. The telemedicine data and pictures were diagnosed by 15 dermatologists. The 299 cases contained 1-22 clinical images each (median 3). Nine dermatologists finished all the cases and the remaining six completed some of them, thus providing 2893 decisions. Overall, 61% of all cases were rated as possible to diagnose and of those, 80% were correct in comparison with the face-to-face diagnosis. Image quality was evaluated and the median was 5 on a 10-point scale. There was a significant correlation between the correct diagnosis and the quality of the photographs taken (P < 0.001). In nearly two-thirds of all cases, a teledermatology diagnosis was possible; however, there was insufficient information to make a telemedicine diagnosis in about one-third of the cases. If applied carefully, mobile phones could be a powerful tool for people to optimize their health care status.
    Journal of Telemedicine and Telecare 06/2013; 19(4):213-8. DOI:10.1177/1357633X13490890 · 1.74 Impact Factor
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    ABSTRACT: We present a case of an amelanotic nodular melanoma occurring in a 26-year-old woman who carried a heterozygous (melancortin-1-receptor) MC1R 160R/W and tyrosinase (TYR) 402R/Q genotype and had a dark hair phenotype. We present dermoscopic, reflectance confocal microscopy (RCM) and histopathological images of the melanoma. We discuss the relationship between MC1R red hair colour (RHC) variants, TYR variants, phenotype and melanoma development. We also discuss the merits of RCM as an additional diagnostic aid for equivocal melanocytic lesions.
    Australasian Journal of Dermatology 04/2012; 53(4). DOI:10.1111/j.1440-0960.2012.00882.x · 0.98 Impact Factor
  • Heidi Rolfe, Elisabeth Wurm, Stephen Gilmore
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    ABSTRACT:   Striae distensae, otherwise known as stretch marks, are white or red scar-like streaks on the skin. Although they are not associated with adverse health outcomes, striae are associated with significant cosmetic morbidity. While they have been well characterised histopathologically, a non-invasive method of microscopic lesion assessment of striae would be welcome.   To gain insight into the small-scale morphological features associated with striae we undertook an in vivo investigation of nine patients with striae alba and one with striae rubra utilising reflectance confocal microscopy (RCM).   Here we demonstrate that features known to be present using light microscopy, such as parallel collagen bundles in the dermis, and some features that are not well recognised by light microscopy, including distortion of dermal papillae, are demonstrable using RCM.   Characterising the features of early and established striae distensae with confocal microscopy is an important foundation for future work. The potential ability to reliably identify the earliest pathological changes in skin in early lesions or before clinically manifest striae develop--a task facilitated by our findings--will increase the understanding of their pathogenesis and will have significant practical utility in monitoring the impact of future preventative interventions.
    Australasian Journal of Dermatology 03/2012; 53(3):181-5. DOI:10.1111/j.1440-0960.2012.00884.x · 0.98 Impact Factor
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    ABSTRACT: It is well recognized that the number and patterns of acquired melanocytic naevi vary with age, but little is known about naevus patterns in the elderly. This is a cross-sectional study assessing the prevalence, dermoscopic pattern and anatomical distribution of naevus subtypes in a stratified cohort aged between 60 and 89 years. Fifty-nine patients who attended the Queensland Institute of Dermatology were recruited randomly and evenly distributed into three age groups: 60-69 years; 70-79 years; and 80-89 years. For each participant, total naevus count and morphological naevus types were recorded with respect to age, sex and anatomical location. Flat (Clark's) naevi were further subclassified according to the dermoscopic pattern as reticular, globular or structureless. Using non-parametric methods, naevus counts in the elderly decreased due to the disappearance of reticular naevi (P < 0.05). By contrast, structureless and intradermal (Unna's and Miescher's) naevi seemed to persist even into older age. Naevi on the trunk, limbs, head and neck represented 57.6%, 31.0% and 11.3%, respectively. Notably, no reticular naevi were found on the head and neck area. There is a progressive reduction in total naevus counts with advancing age with respect to a cohort aged greater than 60 years.
    Australasian Journal of Dermatology 11/2011; 52(4):254-8. DOI:10.1111/j.1440-0960.2011.00794.x · 0.98 Impact Factor
  • Source
    Elisabeth Mt Wurm, Claudia Es Curchin, H Peter Soyer
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    ABSTRACT: Early detection of lesions while minimising the unnecessary removal of benign lesions is the clinical aim in melanoma diagnosis. In this context, several non-invasive diagnostic modalities, such as dermoscopy, total body photography, and reflectance confocal microscopy have emerged in recent years aiming at increasing diagnostic accuracy. The main developments in this field are the integration of dermoscopy and digital photography into clinical practice.
    F1000 Medicine Reports 06/2010; 2. DOI:10.3410/M2-46
  • Elisabeth M. Wurm, H Peter Soyer
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    ABSTRACT: Non-invasive diagnostic tools aim at increasing accuracy of melanoma diagnosis. Clinical naked eye observation in combination with dermoscopy can be regarded as the practical reference standard to identify lesions for histopathological evaluation. Pigmented lesions need to be evaluated in the context of patient history to identify risk factors for melanoma, followed by a dermoscopically-aided entire skin examination. Patients with identified risk factors should be further examined. Total body photography is widely used in the follow-up of high-risk patients (particularly those with numerous and dysplastic naevi) and can be coupled with digital dermoscopy or videodermoscopy. New noninvasive diagnostic aids comprise multispectral image analysis, reflectance confocal microscopy and computer assisted diagnostic systems. Also, molecular profiling of lesions is an emerging technique under investigation for melanoma diagnosis. Copyright 2010 National Prescribing Service Ltd.
  • [Show abstract] [Hide abstract]
    ABSTRACT: We investigated the diagnostic agreement between teledermatology based on images from a mobile phone camera and face-to-face (FTF) dermatology. Diagnostic agreement was assessed for two teledermatologists (TD) in comparison with FTF consultations in 58 subjects. In almost three-quarters of the cases (TD1: 71%; TD2: 76%), the telediagnosis was fully concordant with the FTF diagnosis. Furthermore, the diagnosed diseases were almost all in the same diagnostic category (TD1: 97%; TD2: 90%). If mobile teledermatology had been used for remote triage, TD1 could have treated 53% subjects remotely and 47% subjects would have had to consult a dermatologist FTF. TD2 could have treated 59% subjects remotely, whereas 41% subjects would have had to consult a dermatologist FTF. Forty-eight subjects responded to a questionnaire, of whom only 10 had any concerns regarding teledermatology. Thirty-one subjects stated that they would be willing to pay to use a similar service in future and suggested an amount ranging from euro5 to euro50 per consultation (mean euro22) (euro = pound0.7, US $1.4). These results are encouraging as patient acceptance and reimbursement represent potential obstacles to the implementation of telemedicine services.
    Journal of Telemedicine and Telecare 02/2008; 14(1):2-7. DOI:10.1258/jtt.2007.070302 · 1.74 Impact Factor
  • British Journal of Dermatology 05/2006; 154(4):801-2. DOI:10.1111/j.1365-2133.2006.07175.x · 4.10 Impact Factor
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    ABSTRACT: Mobile telemedicine is becoming more and more important in the 21st century. As a visual profession dermatology provides perfect conditions for using telemedicine tools in general and mobile devices in particular. Teledermatology advances the reliability of diagnosis by expert consultations without expensive and time-consuming relocations. Consecutively, the quality of patient's care will be raised and the costs of the health care system can be reduced. Die mobile Telemedizin erlangt im 21. Jahrhundert zunehmend größere Bedeutung. Die Dermatologie als visuelles Fach eignet sich paradigmatisch, die vielfältigen Möglichkeiten der Telemedizin im Allgemeinen und der mobilen Endgeräte im Speziellen zu nutzen. Die Teledermatologie verbessert die Diagnosesicherheit durch die Möglichkeit von Expertenkonsultationen ohne kostspielige und zeitraubende Standortwechsel. Dies führt zu einer Verbesserung in der Qualität der Patientenversorgung sowie zu Kosteneinsparungen im Gesundheitssystem.
    e & i Elektrotechnik und Informationstechnik 03/2006; 123(4):148-151. DOI:10.1007/s00502-006-0333
  • e & i Elektrotechnik und Informationstechnik 01/2006; 123(4):148-151.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Mobile telemedicine is becoming more and more important in the 21st century. As a visual profession dermatology provides perfect conditions for using telemedicine tools in general and mobile devices in particular.Teledermatology advances the reliability of diagnosis by expert consultations without expensive and time-consuming relocations.Consecutively, the quality of patient's care will be raised and the costs of the health care system can be reduced.
  • Archives of Dermatology 11/2005; 141(10):1319-20. DOI:10.1001/archderm.141.10.1319 · 4.31 Impact Factor

Publication Stats

130 Citations
14.82 Total Impact Points


  • 2012
    • University of Queensland
      • Dermatology Research Centre
      Brisbane, Queensland, Australia
  • 2005–2006
    • Medical University of Graz
      • Universitätsklinik für Dermatologie und Venerologie
      Gratz, Styria, Austria