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


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Pediatric teledermatology: Observations based on 429 consults

Tina S. Chen, MDa, Marc E. Goldyne, MD, PhDb, Erin F.D. Mathes, MDbc, Ilona J. Frieden, MDbc, Amy E. Gilliam, MDbcCorresponding Author Informationemail address

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.

Limitations

Limitations were the inability to generalize the data from the population studied and the chances of error and bias in teledermatology diagnoses.

Conclusions

Store-and-forward teledermatology can improve diagnostic and therapeutic care for skin disease in children who lack direct access to dermatologists.

a Department of Dermatology, University of California, Irvine, California

b Department of Dermatology, University of California, San Francisco, California

c Department of Pediatrics, University of California, San Francisco, California

Corresponding Author InformationReprint requests: Amy E. Gilliam, MD, Palo Alto Medical Foundation, 795 El Camino Real, Clark Bldg, Palo Alto, CA 94301.

 Funding sources: None.

 Conflicts of interest: None declared.

PII: S0190-9622(09)00675-6

doi:10.1016/j.jaad.2009.05.039


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