Ashley thought her dark toenail was a runner’s issue but discovered the problem was far more complex after a second opinion from a Teladoc online dermatologist.
Ashley is meticulous.
A prosecutor and avid runner, Ashley is used to dealing with facts and measuring figures, gathering evidence and refusing to quit until the job—or race—is complete. She’s proactive and diligent; every mile she completes and every case she tries is an opportunity to exceed expectations.
Ashley expects that her healthcare experience will be as effective as she is.
So when Ashley’s doctor diagnosed hyperpigmentation on her toenail as a fungus, she wanted Teladoc on her team. “I tried other virtual doctors before, and I liked not having the need to physically go to the doctor,” she said. “When they added dermatology, I was thrilled because where I go, it takes a long time to get an appointment.”
A previous experience with an online Teladoc dermatologist went well when Ashley sought care for her eyelid. The treatment plan was delivered quickly and offered fast relief, so Ashley knew where she’d turn for a second opinion on her toe diagnosis.
“I thought, I’m comfortable with Teladoc. So I submitted my pictures, and they got back to me quickly. They said that they didn’t think it was a fungus. They said that they thought it could be melanoma or an abnormal mole, and they suggested that I follow up with someone in person. So that put it on my radar and made me more persistent with my doctor. I got an appointment at the physical clinic, and they set me up for a biopsy.”
A close call
It turned out to be a benign issue in Ashley’s case, but melanoma is far from a benign concern—especially for people of color. For those who possess skin rich in melanin, instances of skin cancer are far less common and can go undetected or be misdiagnosed. These complex factors can often condition some in diverse communities to believe that melanoma isn’t an outcome they should worry about.
“As a runner, [the initial diagnosis] didn’t surprise me because there are a lot of issues that runners have with their toes,” she said. What her Teladoc online dermatologist was careful to consider, however, was that melanomas in Black people, Asians and Native Hawaiians most often occur on nonexposed skin with less pigment, with up to 60% to 75% of tumors arising on the palms, soles, mucous membranes and nail regions.1 And although skin cancer represents 1% to 2% of all cancers in Black people,2 the estimated five-year melanoma survival rate for Black people is only 67%, versus 92% for whites.3
In the United States, 12 million people are affected by medical diagnostic errors each year.4
An estimated 40,000 to 80,000 people die annually from complications from these misdiagnoses.5
Women and people of color are 20% to 30% more likely to be misdiagnosed or subjected to ineffective treatment.6
“In this case, Teladoc put me on to something that I wasn’t thinking of,” Ashley recalls. “Even the dermatologist said that with African Americans, people wouldn’t suspect melanoma and wouldn’t take it seriously. I give credit to the Teladoc dermatologist who looked at the pictures and knew it was something serious.”
Even the dermatologist said that with African Americans, people wouldn’t suspect melanoma and wouldn’t take it seriously. I give credit to the Teladoc dermatologist who looked at the pictures and knew it was something serious.
Ashley
A trusted partner
Teladoc Dermatology (along with all Teladoc services) uses U.S. board-certified doctors and dermatologists who are trained to see past statistically normal occurrences and look for anomalies that could affect health outcomes. In Ashley’s case, that expert approach could have been lifesaving. In minutes and from the comfort of her own home, Ashley uploaded images to her Teladoc app, receiving a treatment plan and diagnosis within 48 hours from a licensed dermatologist. That meant crucial time saved and a second opinion she could prioritize as she considered additional treatment options.
Now, Ashley is a passionate advocate for Teladoc because of its detailed approach to her health concerns. “I’ve told everyone, especially co-workers, about using Teladoc. This is someone at your fingertips who has been vetted, and it’s convenient. I’ve never felt ignored or that they didn’t have time for me—they’re doctors you can rely on.”
Case closed.
If you have concerns about anything related to your skin—from acne to a rash—it’s time to get professional help. Reach out to Teladoc online or by app 24/7 to upload images of your skin condition.
Our U.S. board certified dermatologists will give you a diagnosis and treatment plan customized to fit your specific needs within two days or less.
SOURCES
1Gloster, Hugh M., and Kenneth Neal. 2006. “Skin cancer in skin of color.” Journal of the American Academy of Dermatology, 55(5), 741–764. https://doi.org/10.1016/j.jaad.2005.08.063
2Stern, Robert S. 2010. “Prevalence of a history of skin cancer in 2007: results of an incidence-based model.” Archives of Dermatology, 146(3), 279–282. https://doi.org/10.1001/archdermatol.2010.4
3American Cancer Society. 2021. “Cancer Facts and Figures 2021.” Accessed January 13, 2021. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2021/cancer-facts-and-figures-2021.pdf
4Singh, Hardeep, Ashley N.D. Meyer, and Eric J. Thomas. 2014. “The frequency of diagnostic errors in outpatient care: estimations from three large observational studies involving US adult populations.” BMJ Quality & Safety, 2014;23:727-731. https://qualitysafety.bmj.com/content/23/9/727
5Saber Tehrani, Ali S., HeeWon Lee, Simon C. Mathews, et al. 2013. “25-Year summary of US malpractice claims for diagnostic errors 1986–2010: an analysis from the National Practitioner Data Bank.” BMJ Quality & Safety, 2013;22:672-680. https://qualitysafety.bmj.com/content/22/8/672
6Geiger, Jack H. 2003. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Institute of Medicine (U.S.) Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care. Edited by B.D. Smedley, A.Y. Stith, and A.R. Nelson. Washington, D.C.: National Academies Press (U.S.). https://www.ncbi.nlm.nih.gov/books/NBK220337/
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