Inflammatory skin conditions are well-suited for Telemedicine in Dermatology: Atopic Dermatitis is one of them

• There are two robust studies in atopic dermatitis (2015 in JAMAderm and 2017 in Telemedicine and E-Health) where the authors looked at an overall care for management, and the examined the quality of life in atopic dermatitis patients.

• In the former study, researchers compared the effectiveness of telemedicine appointments to face-to-face appointments in a randomized clinical trial:
  • There were 156 adults and children, in hopes of understanding whether teledermatology could improve access to care for patients with atopic dermatitis.
  • Each patient attended a face-to-face appointment at the initial visit.
  • Thereafter, half attended follow-ups face-to-face with a dermatologist every two months for a year, and the other regularly sent pictures of their skin to remote dermatologist that prescribed treatments remotely.
  • The researchers then measured the severity of eczema among all the patients at the initial office visit and each follow-up visit using two standardized scoring system.
• Results showed uniform improvement of patients’ atopic dermatitis across both groups.
• The latter study (with a similar design to the first one) also demonstrated that when atopic dermatitis patients were seen via telemedicine appointments, their quality of life outcomes improved to the same extent as those seen in person.
• Based on these two studies, the inference is that the telemedicine appointments are as effective as face-to-face appointments for the treatment of atopic dermatitis.
• Advice for picture taking:
  • adequate lighting to properly visualize the entire rash.
  • Make sure that there is no glares or shadows.
  • Use a solid background without patterns.
  • The image should be free of artifacts, tell the patients to take their jewellery or shiny watch or things like that.
  • Avoid altering the images using filter, especially if it is coming from the patient. Instagram or Snapchat filters make it look good, but bring confusion.

Trilokraj Tevasvi, MD. Making online decisions inflammatory dermatoses. 8th World Congress of Teledermatology, Skin Imaging and AI in Skin diseases – November 2020