Teledermatology on par with conventional consultations

Distance dermatology—Porcia Love, MD, a dermatology resident at the Durham VA Medical Center and Duke University, examines an image and clinical notes documenting the skin rash of a patient at a remote location. (Photo by Linnie Skidmore)

Distance dermatology—Porcia Love, MD, a dermatology resident at the Durham VA Medical Center and Duke University, examines an image and clinical notes documenting the skin rash of a patient at a remote location. (Photo by Linnie Skidmore)

For patients with skin problems who live far from a dermatology clinic, telemedicine can be an effective tool for managing their condition, shows a study of 326 Veterans at two sites in Missouri and Minnesota.

All the Veterans in the study had problems such as rashes or growths. About half received usual care, starting with a referral from their primary care provider for an in-person visit to a dermatology clinic.

The others were triaged via telemedicine: Primary care staff took digital photos of the skin problem and filled out a detailed history on it. A VA dermatologist viewed the information in the electronic medical record and made a recommendation. About 6 in 10 telemedicine patients were told to come in to the dermatology clinic, owing to the complexity or severity of the problem. For the others, the dermatologist provided a diagnosis and management plan for the primary care clinic to implement. Those patients were not required to travel to the dermatology clinic for an in-person visit.

When health status and skin-related quality of life were measured nine months later, the scores were roughly equal in both groups. All the patients had improved about the same amount.

The authors of the study point out that while skin conditions such as psoriasis are generally not life-threatening, they can have major impacts on quality of life. They say their study is one of the first to measure the impact of teledermatology on patients' quality of life.

The study appeared online Feb. 20 in JAMA Dermatology.