Teledermatology: current indications and considerations for future use

Beer, Jacob; Hadeler, Edward; Calume, Alejo; Gitlow, Howard S.; Nouri, Keyvan

doi:10.1007/s00403-020-02145-3

Cited by 35 publications

(37 citation statements)

References 28 publications

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“…As previously mentioned, patients living in rural areas have limited access to dermatologists [ 6 ], often being forced to travel great distances for in-person dermatology appointments. By providing at-home care, TD cuts travel costs for patients and eliminates time spent driving to a doctor’s office [ 10 ]. In addition to reduced travel costs, a 2019 study in Philadelphia revealed that TD reduces medical costs for patients because timely access to care provided by TD reduces urgent care and emergency department visits.…”

Section: Discussionmentioning

confidence: 99%

Teledermatology During COVID-19: An Updated Review

2021

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The coronavirus disease 2019 (COVID-19) pandemic has fundamentally transformed the landscape of providing dermatologic care. In an age of lockdowns and social distancing, teledermatology (TD) has emerged as a powerful tool to deliver remote care. Here, we review literature on TD use during the pandemic to evaluate the positives and negatives of TD implementation. We especially consider the reception of TD in underserved communities and the developing world as well as the ethico-legal challenges wrought by the burgeoning utilization of this new paradigm of care. The potential of TD to occupy a more prominent role in dermatologic care in a post-COVID-19 world is also discussed.

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Section: Discussionmentioning

confidence: 99%

Teledermatology During COVID-19: An Updated Review

2021

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“…In fact, Anderesen et al, through a retrospective review of the teledermatology database in the Faroe Islands, a group of 18 islands in the North Atlantic, concluded that teledermatology is indispensable in specific contexts, such as rural areas, while in non-rural ones, should be destined to evaluate which disease can benefit from either in-person or online visits to give selectivity on resources destined for telemedicine [ 12 ]. Moreover, since the worldwide spread of the SARS-CoV-2 infection at the end of 2019, telemedicine has gained an increasingly important role in daily clinical practice, especially regarding patients affected by chronic diseases, such as psoriasis [ 16 , 17 ]. Villani and colleagues implemented an already existing teleconsultation service that was originally reserved for emergencies, and that turned routine during the COVID-19 pandemic, given the need to avoid social contacts [ 13 ].…”

Section: Resultsmentioning

confidence: 99%

“…Such measures appeared to be very important, particularly for those patients under immunosuppressive drugs that were at high risk of contracting the infection [ 13 ]. In general, Beer, Chambers, Pearlman, and Frühauf accordingly reported in their studies that online interactions were well accepted by patients and highly preferred to in-person visits [ 16 , 17 , 18 , 19 ]. Moreso, Yi et al noticed a slight decrease in access to telehealth services for elderly and non-English speaker patients, suggesting potential unequal access to care for these vulnerable patients [ 20 ].…”

Section: Resultsmentioning

confidence: 99%

Teledermatology and Inflammatory Skin Conditions during COVID-19 Era: New Perspectives and Applications

Marasca

Annunziata

Camela

et al. 2022

JCM

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Background: The most frequent inflammatory skin diseases are psoriasis, atopic dermatitis, hidradenitis suppurativa, and acne. Their management is challenging for dermatologists since their relapsing chronic clinical course is associated with a great impact on quality of life. Nevertheless, the recent introduction of novel therapies, such as biological drugs and small molecules has been changing the history of these diseases. Methods: A systematic review of the scientific literature of case reports, case series, epidemiological studies, reviews, and systematic reviews regarding teledermatology and inflammatory skin disease. Studies were identified, screened, and extracted for relevant data following the PRISMA (preferred reporting items for systematic reviews and meta-analyses) guidelines. Results: A total of 69 cases articles were included in the review. Conclusions: As we have shown in the review, several experiences of teledermatology for patients affected by inflammatory skin diseases have been demonstrated to increase due to clinical access to hospital and specialized health care services, allowing better access to specialized dermatology care for people living in remote areas, and saving costs and money with health care.

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“…Therefore, expanding the training set could substantially increase the performance of the CNN CORAL for automated PASI scoring. With the increasing interest in tele-dermatology and at-home hospital care, 28 image-based automated PASI scoring by CNNs may not only provide objective PASI scoring in clinical practice and research, but may facilitate reliable psoriasis severity assessments for remote consultations in the future by incorporating the algorithm into a mobile application that could be used at home. In conclusion, CNNs have the potential to automatically perform image-based PASI scoring at an anatomical region level.…”

Section: Discussionmentioning

confidence: 99%

Image‐based automated Psoriasis Area Severity Index scoring by Convolutional Neural Networks

Schaap

Cardozo

Patel

et al. 2021

Acad Dermatol Venereol

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Background The Psoriasis Area and Severity Index (PASI) score is commonly used in clinical practice and research to monitor disease severity and determine treatment efficacy. Automating the PASI score with deep learning algorithms, like Convolutional Neural Networks (CNNs), could enable objective and efficient PASI scoring. Objectives To assess the performance of image-based automated PASI scoring in anatomical regions by CNNs and compare the performance of CNNs to image-based scoring by physicians.Methods Imaging series were matched to PASI subscores determined in real life by the treating physician. CNNs were trained using standardized imaging series of 576 trunk, 614 arm and 541 leg regions. CNNs were separately trained for each PASI subscore (erythema, desquamation, induration and area) in each anatomical region (trunk, arms and legs). The head region was excluded for anonymity. Additionally, PASI-trained physicians retrospectively determined imagebased subscores on the test set images of the trunk. Agreement with the real-life scores was determined with the intraclass correlation coefficient (ICC) and compared between the CNNs and physicians.Results Intraclass correlation coefficients between the CNN and real-life scores of the trunk region were 0.616, 0.580, 0.580 and 0.793 for erythema, desquamation, induration and area, respectively, with similar results for the arms and legs region. PASI-trained physicians (N = 5) were in moderate-good agreement (ICCs 0.706-0.793) with each other for image-based PASI scoring of the trunk region. ICCs between the CNN and real-life scores were slightly higher for erythema (0.616 vs. 0.558), induration (0.580 vs. 0.573) and area scoring (0.793 vs. 0.694) than image-based scoring by physicians. Physicians slightly outperformed the CNN on desquamation scoring (0.580 vs. 0.589).Conclusions Convolutional Neural Networks have the potential to automatically and objectively perform image-based PASI scoring at an anatomical region level. For erythema, desquamation and induration scoring, CNNs performed similar to physicians, while for area scoring CNNs outperformed physicians on image-based PASI scoring.

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Teledermatology: current indications and considerations for future use

Cited by 35 publications

References 28 publications

Teledermatology During COVID-19: An Updated Review

Teledermatology During COVID-19: An Updated Review

Teledermatology and Inflammatory Skin Conditions during COVID-19 Era: New Perspectives and Applications

Image‐based automated Psoriasis Area Severity Index scoring by Convolutional Neural Networks

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