10.5826/dpc.1401a61
text/xml
2160-9381
3523
en
Jasmine Tran
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
health system management
Potential Benefits of Non-Fungible Tokens (NFTs) and Blockchain Technology in Dermatology
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Opinion
2024-01-31
2023-05-09
2024-01-31
2024-02-21
e2024061
Dermatol Pract Concept
Jasmine Tran
2024/01/31
10.5826/dpc.1401a61
e2024061
School of Medicine, Indiana University, Indianapolis, Indiana, United States
2160-9381
health system management
en
e2024061
Payne T, Fellner J, Dugowson C, Liebovitz D, Fletcher G. Use of more than one electronic medical record system within a single health care organization. Appl Clin Inform. 2012;3(4):462-474. DOI: 10.4338/ACI-2012-10-RA-0040. PMID: 23646091. PMCID: PMC3613036.
Potential Benefits of Non-Fungible Tokens (NFTs) and Blockchain Technology in Dermatology
https://dpcj.org/index.php/dpc/article/download/3523/2448
    Potential Benefits of Non-Fungible Tokens (NFTs)
       and Blockchain Technology in Dermatology
                                       Michael Joseph Diaz1, Jasmine Thuy Tran2


1 College of Medicine, University of Florida, Gainesville, Florida, United States
2 School of Medicine, Indiana University, Indianapolis, Indiana, United States



Citation: Diaz MJ, Tran JT. Potential Benefits of Non-Fungible Tokens (NFTs) and Blockchain Technology in Dermatology. Dermatol Pract
Concept. 2024;14(1):e2024061. DOI: https://doi.org/10.5826/dpc.1401a61
Accepted: August 29, 2023; Published: January 2024
Copyright: ©2024 Diaz et al. This is an open-access article distributed under the terms of the Creative Commons Attribution-
NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use,
distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing Interests: None.
Authorship: Both the authors have contributed significantly to this publication.
Corresponding Author: Michael Joseph Diaz, BS, 1600 SW Archer Rd, Gainesville, FL 32610 Email: michaeldiaz@ufl.edu




To the Editor,                                                             a peer-to-peer network of transactions secured by hash
                                                                           functions, which generate verifiable 256-bit signatures for
    Imaging has revolutionized dermatology by enabling non-                each ledger transaction. Blockchain technology, therefore,
invasive visualization of skin conditions, enhancing di-                   permits immutable digital ownership in the form of NFTs.
agnostic capabilities, and guiding personalized treatment                  These assets demonstrate early signs of unlocked potential
approaches. A 2015 survey of 153 board-certified derma-                    in dermatology, specifically: the health imaging storage and
tologists depicted the prevalence of medical photography                   retrieval spaces, wherefore the need for standardization (ie
with 61.8% reporting everyday use, most frequently in cases                Digital Imaging and Communication in Medicine [DICOM],
of marking biopsy sites (87.5%), tracking disease (82.9%),                 ‘DICODerma’ [2]) has drawn considerable interest by the
and for pedagogical purposes (72.4%) [1]. Amidst burgeon-                  International Skin I­ maging Collaboration [3].
ing advancements in blockchain technology, there is poten-                     The security afforded by cryptographic hash function
tial for non-fungible tokens (NFTs) to be utilized in storing              indicates a role for NFTs in the control of dermatologic
dermatologic images securely yet transparently, providing a                patient data. Upwards of 200 million individual electronic
more efficient and cost-effective option to manage patient                 health records (EHR) were breached from 2010-2020 in the
health information.                                                        United States alone [4]. EHR data and e-prescribing software
    Put simply, NFTs are tradeable assets that represent any               are susceptible to cyberattacks of blackmail and extortion
number or class of unique digital objects. The NFT’s rep-                  schemes due to stored patient identifiers and financial in-
resentative reach is limitless: one may mint (or monetize)                 formation (eg “WannaCry” in 2017 and “Ryuk” in 2020).
NFTs of artwork, real estate, and even patient health data.                Gandhi and colleagues previously remarked that while paid
NFTs are non-interchangeable, non-replicable data pack-                    cloud storage in dermatology (ie Amazon Web Services or
ets stored on a digital ledger known as a “blockchain.”                    Google Cloud) lends increased capacity and privacy with
The blockchain platform, most commonly Ethereum, is                        ‘zero logs,’ concerns remain related to service costs and the




Opinion | Dermatol Pract Concept. 2024;14(1):e2024061                                                                                 1
need for a third party to host this data [5]. Continuing, a 2018   plus enhanced interdepartmental communication. Patients
cross-sectional questionnaire study of patients with psoriasis     may benefit from heightened data privacy and ownership
reported that 100% (181/181) would like to know where              protocols. From demonstrated efficiency to favorable eth-
and how their medical data is stored and 96.7% (178/181)           ics, attention to Web3’s everchanging landscape may soon
agree they should decide who has access to their data [6].         be principal to ethical and successful patient management in
NFTs could replace dated recordkeeping architecture with           dermatology.
proof-of-stake (PoS, available on coming Ethereum 2.0) or
predecessor Ethereum 1.0 proof-of-work (PoW) protocols.
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consensus,” or a highly robust method validation of the             1. Milam EC, Leger MC. Use of medical photography among
                                                                       dermatologists: a nationwide online survey study. J Eur Acad
blockchain transaction timeline, rendering the PoS/PoW
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                                                                       /jdv.14839. PMID: 29405432.
    In the context of NFTs, cryptographic hashing also offers       2. Eapen BR, Kaliyadan F, Ashique KT. DICODerma: A Practical
excellent search ability (owed to constant time complexity             Approach for Metadata Management of Images in Dermatology.
‘O(1)’ and unique indexing IDs), data caching, and data                J Digit Imaging. 2022;35(5):1231-1237. DOI: 10.1007/s10278
integrity validation (via comparison of hashes to identify             -022-00636-5. PMID: 35488074. PMCID: PMC9054111.
                                                                    3. Caffery LJ, Clunie D, Curiel-Lewandrowski C, Malvehy J,
data alteration or tampering). Ethereum Keccak-256 cryp-
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                                                                    5. Gandhi S, Kaliyadan F, Chatterjee K, Sharma A. “Storage, Backup
(see 210 ILCS 85/6.17 (c)). Given additional projections that          and Archiving of Images”- E-Dermatology Task Force (IADVL
health systems will generate > 2,000 exabytes of data each             Academy). Indian Dermatol Online J. 2022;13(3):321-325.
year by 2030 [7], the benefits of hashing are becoming in-             DOI: 10.4103/idoj.idoj_642_21. PMID: 36225997. ­         PMCID:
creasingly attractive.                                                 PMC9549558.
                                                                    6. Klein TM, Augustin M, Otten M. How should electronic
    Moreover, the blockchain effectively serves as a com-
                                                                       health records be designed? A cross-sectional study in patients
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                                                                       with psoriasis. BMC Med Inform Decis Mak. 2019;19(1):218.
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and significant liability concerns faced by dermatologists in          PMC6849227.
the event of an EHR malfunction or failure [9]. Hospital            7. Telenti A, Jiang X. Treating medical data as a durable asset. Nat
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medical record (EMR) vendors across various healthcare
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                                                                       store for small to medium-sized dermatology practices? Cutis.
The utilization of > 1 EMR system magnifies the likelihood             2013;92(6):274-276. PMID: 24416741.
of missing vital clinical information and incomplete allergy/       9. Goldberg D. The Liability of an Electronic Health Record Sys-
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                                                                       -electronic-health-record-system
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                                                                   10. Payne T, Fellner J, Dugowson C, Liebovitz D, Fletcher G. Use
    The advent of NFTs and supporting blockchain technol-
                                                                       of more than one electronic medical record system within a sin-
ogy has ushered in an era of true digital democracy, which             gle health care organization. Appl Clin Inform. 2012;3(4):462-
bodes well for visual fields such as dermatology. For health           474. DOI: 10.4338/ACI-2012-10-RA-0040. PMID: 23646091.
systems, these developments proffer high data compression              ­PMCID: PMC3613036.




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