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Volume 62, Issue 1 , Pages 61-66, January 2010

Pediatric teledermatology: Observations based on 429 consults

Tina S. Chen, MD
- Department of Dermatology, University of California, Irvine, California
Marc E. Goldyne, MD, PhD
- Department of Dermatology, University of California, San Francisco, California
Erin F.D. Mathes, MD
- Department of Dermatology, University of California, San Francisco, California
- Department of Pediatrics, University of California, San Francisco, California
Ilona J. Frieden, MD
- Department of Dermatology, University of California, San Francisco, California
- Department of Pediatrics, University of California, San Francisco, California
Amy E. Gilliam, MD
- Department of Dermatology, University of California, San Francisco, California
- Department of Pediatrics, University of California, San Francisco, California
- Reprint requests: Amy E. Gilliam, MD, Palo Alto Medical Foundation, 795 El Camino Real, Clark Bldg, Palo Alto, CA 94301.

Accepted 26 May 2009. published online 19 November 2009.

Background

Store-and-forward teledermatology is an emerging means of access for patients with skin disease lacking direct access to dermatologists.

Objectives

We sought to examine the patient demographics, diagnostic concordance, and treatment patterns in teledermatology for patients younger than 13 years.

Methods

We conducted a descriptive retrospective cohort study involving 429 patients.

Results

Diagnoses were concordant in 48% of cases, partially concordant in 10%, and discordant in 42%. Management recommendations were concordant in 28% of cases, partially concordant in 36%, and discordant in 36%. Primary care providers tended to underuse topical steroids and overuse topical antifungals and systemic antibiotics. Only 1.4% and 6.0% of patients required repeated teledermatology consultation and in-person dermatology consultation, respectively.