Dermatology Appointments Research Articles

53464 Wait Times for Dermatology Appointments in Puerto Rico

53464 Wait Times for Dermatology Appointments in Puerto Rico

Wait times for scheduling appointments with hospital affiliated dermatologists in New York City

Patients’ experience accessing dermatologic care is understudied. The purpose of this cross-sectional study was to examine current wait times for new patients to receive dermatological care in NYC. Websites at 58 accredited private and public hospitals in the five boroughs of NYC were reviewed to identify dermatology practices. Office telephone numbers listed on each website were called to collect information pertaining to whether the physician was accepting new patients, type of insurance accepted (public, private, both, or none), and the number of days until a new patient could be seen for an appointment. Data pertaining to the time kept on hold and availability of web-based booking were also collected. Mean waiting time for an appointment was 50 days [standard deviation, SD 66] – nearly 2 months, but the distribution was considerably skewed. The median waiting time was 19.5 days [Interquartile range, IQR 4–60]. The time kept on hold to make the appointment was negligible at about 1 min (63 s, SD = 77) but could take up to ~ 7 min. Two-thirds of dermatologists accepted private, Medicare, and Medicaid insurance (n = 228, 66%); a small number accepted only private insurance (n = 12, 4%) or no insurance at all (n = 16, 5%). The median waiting time for an appointment for the 228 providers that accepted Medicaid was 30.5 days (IQR = 5.0-73.25) while for providers who did not accept Medicaid (n = 116) the median wait time for an appointment was 13.0 days (IQR = 3.0–38.0). Just over half (56%) of the dermatologists allowed for appointments to be booked on their website (n = 193). This research highlights the necessity of incorporating new strategies into routine dermatology appointments in order to increase treatment availability and decrease healthcare inequality.

Access to Dermatological Appointments Based on Insurance Types in Hawai'i.

Although there is evidence that Medicaid beneficiaries in the continental United States experience barriers to accessing dermatological care, limited data exists on whether these same barriers exist in Hawai'i. Using a secret shopper study design, a total of 46 dermatology offices were contacted, 41 (89%) of which were accepting new patients. Thirty (73%) offices were located on O'ahu, and the remaining 11 (27%) were distributed among the neighboring islands (Hawai'i Island, Kaua'i, Maui). Overall, the acceptance rate for Medicaid (n=14) was 34%, which was significantly lower (P<.0001) than private insurance (n=39 (95%)) and Medicare (n=38 (93%)). The acceptance rate for patients with Medicaid insurance was lower for O'ahu offices (27%) than for neighboring islands' offices (55%), but the difference was not statistically significant (P=.095). Differences in average wait times were not statistically significant among insurance types or between O'ahu and neighboring islands. Overall, these results suggest that Medicaid recipients compared to those with private insurance or Medicare might experience difficulty in accessing dermatological care in Hawai'i.

Social media use among adolescents with acne: A cross-sectional survey study.

Social media is increasingly used by patients for the management of skin conditions like acne, despite the potential risk for low-quality information. This study surveyed 45 participants between the ages of 12 and 17 years to investigate factors that could be associated with social media use among adolescents with acne. The likelihood of social media use was not significantly increased by clinical severity of acne, more severe physical barriers (greater than or equal to 20 miles to the dermatology clinic), more severe temporal barriers (waiting 12 or more weeks for a first dermatology appointment), or worsened quality of life (assessed via the Skindex-Teen score). This study increases understanding of adolescents' social media behaviors, particularly as a way to seek information for skin conditions like acne.

Hidradenitis Suppurativa Patient Referrals to a Canadian Community Dermatology Practice: A Retrospective Chart Review.

Awareness of hidradenitis suppurativa (HS) among non-dermatology healthcare providers is essential to facilitate prompt diagnosis, treatment, and referral to dermatology for further management. The purpose of this study was to analyze recent referrals to a Canadian community dermatology practice and compare the diagnostic concordance rates for HS between dermatologists and non-dermatologists. This study was a single-centre, retrospective chart review that was completed at Beacon Dermatology in Calgary, AB. Patients who were referred by a non-dermatologist for suspicion of HS and/or were diagnosed with HS by a dermatologist at Beacon Dermatology for the first time between May 2020 and May 2023 were included. Referral letters and dermatology clinic notes were analyzed to extract patient demographics, suspected pre-referral and post-referral diagnoses, and interim management plans that were initiated by the referring provider. A total of 451 patient charts with suspected and/or confirmed HS were retrieved from the clinic database. The median wait time from referral to the first dermatology appointment was 9.1 weeks. The average duration of HS symptoms was 7.3 years. HS was suspected by the referring provider and confirmed by a dermatologist in 286 cases (63%). Preliminary management was initiated in 60% of mild and 66% of moderate-to-severe cases. Given the prolonged time to diagnosis of HS, increasing awareness among healthcare providers is essential. Furthermore, this study highlighted the low implementation rates for evidence-based treatment options in preliminary management plans. Ultimately, this study demonstrates the need for increased interdisciplinary education on HS management in Canada.

Abstract 14776: Myopericarditis Mimicking Myocardial Infarction With Non-Obstructive Coronary Arteries

This is a case of a 76-year-old female with a past medical history of recurrent paroxysmal symptomatic supraventricular tachycardia (SVT), atherosclerotic heart disease, mild aortic and mitral valve regurgitation, mild-moderate tricuspid regurgitation, right bundle branch block, hypothyroidism and bronchiectasis who presented to her dermatology appointment with palpitations and dizziness. She visited the cardiologist's office and was found to have SVT on electrocardiogram which did not terminate with Valsalva maneuvers. She arrived at the emergency department with chest pain and converted to sinus rhythm after 6 mg of intravenous adenosine was administered. Her troponin peaked to 0.21 and she was admitted with concerns for non-ST segment elevation myocardial infarction. Transthoracic echocardiogram showed left ventricular ejection fractions of 61 percent with no wall motion abnormalities and left atrial and inferior vena cava dilation. She underwent left heart catheterization which only showed mild calcification and minimal luminal irregularities of the left anterior descending artery. Cardiac MRI showed myopericarditis and she was discharged with 0.6 mg of colchicine twice daily with plans for outpatient follow up. Discussion Patients with myocardial infarction with non-obstructive coronary arteries (MINOCA) are discovered to have myocarditis on cardiac MRI 25-30% of time. However, this case uniquely demonstrates myopericarditis as the cause for MINOCA which may not have been previously specified. In addition, it is important to emphasize the utility of Cardiac MRI as a non-invasive modality to diagnose MINOCA “mimics”, especially in the female population.

PA20 Assessing the value of transition readiness assessment clinics within a dermatology service

Abstract Successful transition of healthcare from paediatric to adult services is a key component of developmentally appropriate healthcare for young people with long-term conditions. Poor preparation for transfer and shifting social roles results in up to 25% of young individuals regularly missing follow-up visits and poor treatment adherence once transferred to adult services. Transition clinics were developed as an intervention to support young people in navigating the journey from paediatric to adult care. The Ready Steady Go (RSG) tool was implemented by Southampton Children’s hospital and endorsed by the Royal College of Paediatrics and Child Health and the National Institute for Health and Care Excellence for use in transition clinics. It considers the developmentally appropriate healthcare domains of self-management of long-term conditions, independence and self-advocacy, sexual health, mental health and emotional wellbeing, and activities of daily living (ADLs). The role and success of the RSG tool in many medical specialties has been documented. However, it has not yet been routinely implemented within dermatology departments. The aim of this project was to assess the additional value of the use of the RSG tool by a paediatrician with expertise in adolescent health, in a transition readiness assessment clinic piloted within a dermatology service. Notes of all patients attending the transition clinic between January and December 2022 were reviewed. Details of any interventions provided during the RSG-guided clinical appointment were compared with interventions previously received by the same patients in their routine dermatology appointments over the preceding 24 months. Intervention types included the assessment of independence, verbal advice, written leaflets, links to websites and direction to self-help services. Sixteen patients were seen in the transition clinic and included in the analysis. All patients were seen without their parents for at least part of the consultation. With the use of the RSG tool, 100% of patients received one or more intervention concerning self-management of their long-term condition, self-advocacy and ADLs vs. 44%, 81% and 75% in their previous clinic attendances for each of these domains, respectively. Eighty-seven per cent of patients received advice on sexual health/family planning, and 87% received information on mental health help with use of the RSG tool in the transition clinic, where 0% and 37% patients, respectively, had received information about these domains at previous dermatology appointments. All patients successfully achieved transition, with 44% having attended their first adult dermatology appointment, while the remaining 56% have their adult appointments still pending at time of writing. This study highlights the value and yield of a transition-readiness assessment for paediatric dermatology patients. During this presentation, we will discuss the RSG tool and the practicalities of implementing its use in dermatology services.

BT05 Community and Locality Imaging Centres: innovation in the skin cancer care pathway

Abstract Timely management of patients referred with suspected skin cancer remains challenging due to demand that exceeds the capacity of dermatology departments. Encouraging the attachment of images and key metadata along with referrals from primary care helps promote enhanced clinical referral triage. We describe the process of establishing Community and Locality Imaging Centres (CLICs) that seek not only to promote efficient triage, but also to establish a national pipeline of anonymized images, with linked Digital Imaging and Communications in Medicine (DICOM®) data, to assess the potential for future use of artificial intelligence (AI) algorithms in clinical practice. General practitioners (GPs) can request a CLIC appointment at the time of referral, removing the time pressure and potential technical barriers associated with photography and image attachment. Each centre follows the same standardized image capture and hardware operating procedure, ensuring that high-quality, in-focus digital images are consistently acquired. The CLIC appointments take an average of 15 min, during which a suitably trained healthcare professional obtains written patient consent and, using a National Health Service-approved mobile phone with a dermatoscope attachment, takes paired macroscopic and dermoscopic views of each lesion. Relevant metadata, in line with the recently agreed DICOM standards for dermatology, are recorded for individual lesions, enhancing the utility of each photograph. Paired images and metadata are regularly archived to a secure medical image management system and are linked with the referral, allowing dermatologists to perform enhanced clinical triage and communicate one of the following outcomes directly to the referring GP: routine dermatology appointment, urgent dermatology appointment, direct to biopsy or benign lesion–reassurance and discharge. This process aims to streamline the primary care referral pathway and promote immediate benefits to patient care by reducing unnecessary travel for face-to-face outpatient appointments. The establishment of CLICs in Scotland supports referral optimization by providing an efficient, convenient option for GPs and patients to obtain high-quality clinical photography. This model allows for flexible integration into local services: hospital-based with medical photographers, intermediate secondary care-led centres or community-based primary care hubs. Suspected skin cancer referrals can be efficiently triaged by dermatologists when paired with macroscopic and dermoscopic images and relevant patient metadata compliant with DICOM standards. The same images and metadata, once anonymized, can be securely transferred to a nationwide database for deep learning AI algorithm development. Validated AI programs, with the aim of being deployed at the primary care level, inform opportunities for further enhancement of the referral pathway.

Geospatial analysis of access to dermatology care in Los Angeles County: a cross sectional study.

Geographic maldistribution of dermatologists contributes to disparities in access to dermatologic care. We aimed to investigate the geographic distribution of, and differences in wait times for medical dermatology services in Los Angeles County (LAC). We placed phone calls to 251 dermatology practices in LAC to ask for a new patient appointment for a changing mole. We found West LAC (Service Planning Area [SPA] 5) had the highest number of dermatologists and South LAC (SPA 6) had the lowest (26.1 versus 0 per 100,000 residents, P=0.01). Service Planning Area 6 has a higher non-White, uninsured, and impoverished population than SPA 5. Dermatology appointment wait times and Medicaid acceptance varied between SPAs but was not statistically significant (P=0.37 and P=0.20, respectively). Medicaid-accepting practices had a significantly longer mean wait time for an appointment than practices that did not accept Medicaid (26.1 versus 15.1 days, P=0.003). Regions with predominantly non-White, Spanish-speaking, and medically underinsured residents were found to be disproportionately lacking in dermatologists across LAC, which may contribute to impaired access to dermatology services in LAC.

Post-discharge follow-up attendance after pediatric dermatology consultation in the emergency department: A retrospective analysis.

The emergency department (ED) is a frequent source of care for pediatric patients with dermatologic conditions, possibly owing to limited access to routine and urgent outpatient dermatology appointments. The demographics, clinical characteristics, follow-up scheduling practices, and attendance rates of 50 pediatric and 142 adult patients evaluated by the dermatology consult service in the ED were reviewed. High rates of follow-up attendance were observed in the pediatric and adult populations, with the majority receiving an appointment within 2 weeks. The dermatology consult service may play an important role in facilitating post-discharge access to outpatient care.

Teledermatology to reduce face-to-face appointments in general practice during the COVID-19 pandemic: a quality improvement project

Teledermatology is an important subspecialty of telemedicine that continues to evolve with advances in telecommunication and mobile phone technology. A 19-week primary care quality improvement project collected baseline data and...

Patient factors associated with dermatology outpatient non-attendance: An analysis of racial and ethnic diversity

Non-attendance to dermatology outpatient appointments is a risk factor for poorer patient outcomes. The culturally and linguistically diverse (CALD) communities in Australia have been identified as at risk of poorer health outcomes, but there is a paucity of data assessing patient factors that may increase outpatient non-attendance. To investigate this, we performed a retrospective cross-sectional study of dermatology appointments from patients attending a tertiary, referral public hospital located in one of Australia's most racially and ethnically diverse communities. Patients within the 18-45 years age bracket were 61% more likely not to attend when compared with older age groups. Those born in Oceania, Middle East Asia, and surprisingly Australia were more likely to miss an appointment, whilst those born in East and Southeast Asia were more likely to attend. Those who spoke Arabic at home were more likely not to attend, whilst those who spoke Vietnamese at home were more likely to attend. This study sheds further light on health disparities in non-attendance and emphasizes the importance of not collectively amalgamating all groups of the CALD community.

Willingness of Patients from an Urban Safety-Net Dermatology Clinic to Receive a COVID-19 Vaccine

Background: While recent vaccine development has initiated a return to pre-COVID "normalcy" both in the dermatology clinic and worldwide, significant challenges remain regarding the public’s willingness to receive a COVID-19 vaccine. Dermatologists often discuss vaccinations with their patients and aid them in making evidence-based medical decisions. Previous studies have looked at the U.S. population’s willingness to receive a COVID-19 vaccine, but no studies have examined the dermatology patient population from an urban, safety-net hospital. Studies have shown that understanding the target audience is the first step towards increasing vaccine acceptance. Methods: A cross-sectional, telephone-based survey study was administered to 326 patients of an urban, safety-net hospital from July 2020 to August 2020 in order to assess willingness to obtain a COVID-19 vaccine. Results: Our survey study showed that 57.7% of patients with a recent dermatology appointment are willing to receive a COVID-19 vaccine and that safety concerns represent the main reason for patient hesitancy. Patients who do not regularly receive a flu vaccine, non-Caucasian patients, and those who know someone who tested positive for COVID-19 are less willing to receive a COVID-19 vaccine. Patients with a recent dermatology appointment are more willing to receive a COVID-19 vaccine than those who did not have a recent dermatology appointment. Conclusions: Our results provide dermatologists, especially those working in urban safety-net clinics, with key information about the attitude of patients toward the COVID-19 vaccine.

1618 Improving the Clinic Experience for Surgical Patients Visiting the Melanoma Multidisciplinary Team Clinic at Guy’s and St Thomas’ NHS Foundation Trust

Abstract Aim The incidence of malignant melanoma has been increasing in the UK over the last decade. Effective melanoma management requires a multidisciplinary team (MDT) approach, often involving dermatologists, oncologists, radiologists, histopathologists, skin cancer nurse specialists and plastic surgeons. Patient waiting times at our melanoma MDT clinic at the St John’s Institute of Dermatology at Guy’s Hospital, London had anecdotally been reported as excessive, specifically for same-day ‘in-clinic referrals’ from dermatology to plastic surgery. We aimed to ascertain the reasons for the delay and implement changes to improve patient satisfaction in the clinic. Method A patient satisfaction questionnaire was devised, measuring satisfaction on a numerical scale of 1 (unsatisfied) to 5 (very satisfied) in addition to a clinic staff perception questionnaire on patient satisfaction. Lack of instruction from staff after the dermatology appointment was identified as the predominant factor contributing towards waiting delays to the plastic surgery clinic. This led us to highlight and educate the issue to all team members involved and create a system whereby patients re-reported to the administrative staff after their dermatology appointment to be re-entered into the system. Results As a result of this, the mean surgical patient satisfaction score, pre-intervention of 3.83, improved to 4.50 post-intervention. Similarly, mean scores from staff assessing perception of how well the clinic ran and patient waiting times also increased. Conclusions The introduction of a new patient in-clinic referral protocol and increased staff education of the issue has improved both patient and staff satisfaction within the clinic’s health care provision.

26452 Impact of COVID-19 on patient willingness to seek in-person dermatologic care

The coronavirus-19 (COVID) pandemic has hindered health care provider operations, and its impact on patient willingness to seek in-person dermatologic care lacks extensive study. Understanding how a pandemic may influence patient motivation to consult a dermatologist may facilitate efficient allocation of health care provider resources both during and after COVID. Participants (n = 416) were recruited through Amazon Mechanical Turk, a web-based survey platform. Subjects were randomized to one of fourteen groups, each entailing a pre-COVID or during-COVID hypothetical scenario of a socially stigmatized skin condition: scalp psoriasis, herpes labialis, acne vulgaris, rosacea, tinea faciei, melanoma, or a benign nevus. Subjects rated their willingness to schedule an in-person dermatology appointment on a 5-point Likert scale (ie, willingness score). Sociodemographic data were collected. Herpes labialis, tinea faciei, and melanoma prompted higher willingness scores during COVID (3.94; 4.03; 3.54) compared with pre-COVID (3.81; 4.0; 3.32); scalp psoriasis, acne vulgaris, rosacea, and benign nevi prompted lower willingness scores during COVID (3.33; 2.88; 3.67; 3.07) compared with pre-COVID (3.93; 3.19; 4.21; 3.7). The benign nevus group displayed the largest decrease in willingness scores from pre-COVID (3.7) to during COVID (3.07). Patients reported higher willingness to seek in-person evaluation for conditions associated with stronger social stigmas, such as scalp psoriasis and herpes labialis, during COVID. We did not control for subject familiarity with each skin condition, and perceived degree of disfigurement was not measured. Patient willingness to seek treatment during COVID may be changing rapidly and, at this time, does not appear to be largely affected by the pandemic.

Development of a Teledermatology Service in Rural Washington State Using the Doctor of Nursing Practice Skill Set and Implementation Science

ABSTRACT Teledermatology increases access to dermatologic care in rural communities and is an effective strategy to decrease unnecessary dermatology referrals. At Confluence Health, the largest rural healthcare organization in Washington State, the average dermatology appointment wait time is approximately 7 months. This delay is more than 6 times the national average wait time of 33.9 days, making the need to increase access to care significant. To address this gap in care, a consultation service using store-and-forward teledermatology was designed, guided by the Knowledge-to-Action framework. This framework is an effective tool used in implementation science to guide the translation of evidence-based knowledge into practice. Store-and-forward telehealth allows for asynchronous electronic transmission of digital images to a specialist who later formulates a diagnostic impression and management plan. Since the outbreak of the COVID-19 pandemic, Confluence Health has swiftly adopted real-time video visits and plans to integrate this store-and-forward teledermatology consultation service by December 2020. This article examines a systems-level quality improvement initiative, facilitated by a Doctor of Nursing Practice-prepared nurse practitioner, with the aim of improving access to care and health outcomes.

Factors Contributing to Diagnostic Discordance Between Store-and-Forward Teledermatology Consultations and In-Person Visits: Case Series.

Use of asynchronous store-and-forward (SAF) teledermatology can improve access to timely and cost-effective dermatologic care and has increased during the COVID-19 pandemic. Previous research has found high diagnostic concordance rates between SAF teledermatology and face-to-face clinical diagnosis, but to our knowledge, none have used specific cases to illustrate factors contributing to diagnostic discordance. To identify and illustrate characteristics that may have contributed to diagnostic discordance between store-and-forward teledermatology and in-person clinical diagnosis in a series of patients. We identified 7 cases of diagnostic discordance between teledermatology and in-person visits where the favored diagnosis of the in-person dermatologist was not included in the differential diagnosis formulated by the teledermatologist. Cases were identified from a previously published retrospective chart review of 340 SAF teledermatology consultations, which was previously performed at an academic community health care system in the greater Boston area, Massachusetts, from January 1, 2014, through December 31, 2017. Of 99 patients who completed an in-person dermatology appointment after their teledermatology consultation, 7 had diagnostic disagreement between the teledermatologist and in-person dermatologist where the diagnosis in the in-person consultation was not included in the differential diagnosis in the original teledermatology consult. These 7 cases were examined by 2 author reviewers to identify factors that may have contributed to diagnostic discordance. Factors contributing to diagnostic discordance between SAF teledermatology consultations and in-person visits included poor image quality, inadequate history or diagnostic workup, inability to evaluate textural characteristics, diagnostic uncertainty due to atypical presentations, and evolution in appearance of skin conditions over time. We identified multiple factors that contributed to diagnostic discordance. Recognition and mitigation of these factors, when possible, may help to improve diagnostic accuracy and reduce the likelihood of misdiagnosis. Continuing education of referring providers and implementation of standardized guidelines for referrals may also be helpful in reducing the risk of misdiagnosis due to inherent limitations of teledermatology services.

A labelling system improves parental comfort and willingness to use topical corticosteroids for paediatric atopic dermatitis.

ObjectivesIn the United Kingdom, atopic dermatitis (AD) affects 20% of children and topical corticosteroids (TCS) are a mainstay of AD treatment regimes. Many TCS have similar packaging despite significant differences in potency frequently leading to confusion, and along with misinformation and steroid phobia, potentially reducing treatment adherence. We aimed to evaluate parents' knowledge/concerns regarding TCS and explore benefits of/preference for a TCS‐labelling system.MethodHundred parents of children with AD attending paediatric dermatology and/or allergy appointments completed mixed‐methodology Survey 1 (knowledge‐quiz, TCS‐labelling options, feedback on what supports AD‐care). Thirty parents, adolescents, and healthcare professionals completed Survey 2. Qualitative/quantitative data was thematically/statistically analysed (SPSS v25) respectively.ResultsParents preferred the traffic light system (green = mild, yellow = moderate, red = potent; n = 71/100) and reported significantly increased willingness and comfort in using TCS if a labelling system was used p ≤ 0.001). Knowledge regarding TCS potency was lacking: 62% (n = 46/74) of mild TCS‐users overestimated potency; 51% (n = 67/131) of potent TCS‐users underestimated potency. Common concerns were TCS‐related skin thinning, long‐term side effects and themes for improved AD‐care/support included: better information, written plans, access to advice, involvement of certain staff. Parents wanted accessible information in various formats: verbally, electronic resources, leaflets, and education sessions.ConclusionsParents of children with AD confirmed significant concerns and demonstrated poor knowledge regarding TCS use. Our findings suggest that a simple labelling system may improve TCS adherence. Future work to test refined label prototypes and evaluating their impact on adherence and correct use is needed.

15297 Identification of pathogenic variants in patients with melanoma who meet NCCN criteria for hereditary breast and ovarian cancer and Lynch syndrome testing

Currently, CDKN2A and CDK4 have primarily been implicated in familial melanoma. However, pathogenic variants (PVs) in these genes only represent a small percentage of familial melanoma cases, indicating that other genes may be involved. By looking at the patient family history data of over 500,000 individuals tested with a pan-cancer panel because they met National Comprehensive Cancer Network (NCCN) hereditary breast and ovarian cancer and/or Lynch syndrome criteria, we identified 27,946 patients with a personal history of melanoma or first-degree relative with melanoma. Of these patients, 1932 (6.9%) patients carried a PV in a cancer predisposition gene, which was significantly higher than in individuals with no personal history of any cancer and no first-degree relative with melanoma (5.1%, P < .0001). These PVs were most commonly identified in CHEK2 (n = 356), BRCA2 (n = 313), ATM (n = 268), BRCA1 (n = 242), PALB2 (n = 137), and CDKN2A (n = 121). In this cohort, only one patient had a PV in CDK4. Of the 1520 patients first diagnosed with melanoma who went on to develop an additional primary cancer, 148 (9.7%) had a PV. These individuals went on to develop breast, colorectal, ovarian, or another cancer. Early identification of PV-carrying patients with melanoma would present the provider and patient with the opportunity to prevent the occurrence of a second primary cancer through increased surveillance or risk-reducing surgeries. Identification of patients with concerning family cancer histories eligible for hereditary cancer testing according to NCCN guidelines during dermatology appointments may lead to positive health outcomes by preventing future cancers.

Analysis of availability of online dermatology appointments during the COVID-19 pandemic

To the Editor: ZocDoc is an online appointment scheduling platform that hosts thousands of independent practices and hospitals.1 Wait times for online dermatology appointments have been reported; to our knowledge, the impact of COVID-19 on appointment availability and wait times has not been studied.2 Our objective was to characterize dermatology appointment wait times on ZocDoc based on dermatologist density during the COVID-19 pandemic.