Abstract
BackgroundTeledermatology is a tool that provides accurate diagnosis and has been gaining more emphasis over time. It can be used for triage in primary care attention to address skin conditions improving access and reducing time to treatment for surgical, severe or even lethal diseases.ObjectivesOur main goal was to evaluate the proportion of pediatric patient’s lesions that could be managed using teledermatology in primary care attention. Secondly, we wanted to assess the ten most frequent skin conditions, the most common treatments and the referrals made by the teledermatologists to biopsy, in-presence dermatologist or kept at primary care attention.MethodsA cross-sectional retrospective study involving 6,879 individuals and 10,126 lesions was conducted by store-and-forward teledermatology during one year in the city of Sao Paulo, Brazil. If the photographs taken had enough quality, teledermatologist would diagnose, treat and orient each lesion (if possible), and choose one of three options for referral: direct to biopsy, in-presence dermatologist or kept at primary care attention.ResultsTeledermatology managed 62% of the lesions to be kept at primary care attention, 37% were referred to dermatologists and 1% to biopsy, reducing the mean waiting time for an in-presence visit in 78%. In patients 0–2 years old, lesions related to eczema and benign congenital lesions predominated. From 3–12 years old, eczema was still a major cause of complaint, as well as warts and molluscum. From 13–19 years old, acne was the most significant problem, followed by atopic dermatitis, nevi and warts. The most frequent treatment was emollient.ConclusionTeletriage addressed 63% of the lesions without the need for an in-presence visit, suggesting that teledermatology can manage common diseases and optimize dermatological appointments for the most serious, surgical or complex skin illnesses, reducing the mean waiting time for them.
Highlights
Teledermatology (TD) is a healthcare tool that has been more and more used around the world, mostly because Dermatology has an emphasis on visual diagnosis
Teledermatology managed 62% of the lesions to be kept at primary care attention, 37% were referred to dermatologists and 1% to biopsy, reducing the mean waiting time for an inpresence visit in 78%
If the photo had a good quality, they should formulate the most probable diagnostic hypothesis and choose among three referral options for each lesion assessed: 1) directly to biopsy, 2) to a dermatologist visit or 3) back to the pediatrician in primary care attention with the most probable diagnosis and treatment and/or orientation how to proceed with the investigation or management of the lesion
Summary
Teledermatology (TD) is a healthcare tool that has been more and more used around the world, mostly because Dermatology has an emphasis on visual diagnosis. Many studies have shown to improve access to specialized care using storeand-forward TD, which provides accurate diagnosis and reduces time to treatment, with high patient satisfaction [2]. Typical skin conditions such as mild atopic dermatitis, acne, fungal infections and others are common diseases that would be manageable within the primary care attention service. Teledermatology is a tool that provides accurate diagnosis and has been gaining more emphasis over time It can be used for triage in primary care attention to address skin conditions improving access and reducing time to treatment for surgical, severe or even lethal diseases.
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