The majority of skin lesions in pediatric primary care attention could be managed by Teledermatology


Autoři: Mara Giavina Bianchi aff001;  Andre Pires Santos aff001;  Eduardo Cordioli aff001
Působiště autorů: Department of Telemedicine, Hospital Israelita Albert Einstein, São Paulo, Brazil aff001
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: 10.1371/journal.pone.0225479

Souhrn

Background

Teledermatology is a tool that provides accurate diagnosis and has been gaining more emphasis over time. It can be used for triage in primary care attention to address skin conditions improving access and reducing time to treatment for surgical, severe or even lethal diseases.

Objectives

Our main goal was to evaluate the proportion of pediatric patient’s lesions that could be managed using teledermatology in primary care attention. Secondly, we wanted to assess the ten most frequent skin conditions, the most common treatments and the referrals made by the teledermatologists to biopsy, in-presence dermatologist or kept at primary care attention.

Methods

A cross-sectional retrospective study involving 6,879 individuals and 10,126 lesions was conducted by store-and-forward teledermatology during one year in the city of Sao Paulo, Brazil. If the photographs taken had enough quality, teledermatologist would diagnose, treat and orient each lesion (if possible), and choose one of three options for referral: direct to biopsy, in-presence dermatologist or kept at primary care attention.

Results

Teledermatology managed 62% of the lesions to be kept at primary care attention, 37% were referred to dermatologists and 1% to biopsy, reducing the mean waiting time for an in-presence visit in 78%. In patients 0–2 years old, lesions related to eczema and benign congenital lesions predominated. From 3–12 years old, eczema was still a major cause of complaint, as well as warts and molluscum. From 13–19 years old, acne was the most significant problem, followed by atopic dermatitis, nevi and warts. The most frequent treatment was emollient.

Conclusion

Teletriage addressed 63% of the lesions without the need for an in-presence visit, suggesting that teledermatology can manage common diseases and optimize dermatological appointments for the most serious, surgical or complex skin illnesses, reducing the mean waiting time for them.

Klíčová slova:

Acne – Biopsy – Dermatology – Lesions – Primary care – Telemedicine – Warts – Pediatric dermatology


Zdroje

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Článek vyšel v časopise

PLOS One


2019 Číslo 12