Application of information technology to the medical practice is called telemedicine. The term “teledermatology” is coined by Perednia and Brown in 1995.[1] Till date, diagnostic accuracy,[2] patient–physician willingness and satisfaction, cost-effectiveness, and application of various teledermatology tools[3] with respect to advantages and disadvantages have been studied extensively. Teledermatology application to subspecialty care such as geriatric,[4] pediatric,[5] and recently, emergency dermatology[6] care is applied. Teledermatology follow-up care for specific dermatological conditions like psoriasis,[7,8] leprosy,[9] leg ulcers,[10,11] and acne[12] is evaluated.
In future, melasma, leprosy, sexually transmitted infection, and HIV and AIDS cutaneous care need to be applied extensively by TC. In this issue, the advances in information technology and COVID-19 pandemic and consequent lockdown situation globally have resulted in the facilitation of teledermatology consultation (TC). In this context, Clinical Dermatology Review journal comes with a special issue on TC, highlighting the progress made in this field.
In this issue, a systematic review by Kanthraj[13] identifies around 20 important factors that have contributed to the growth of TC. The author identifies and analyzes how these factors have made TC a matured application to deliver dermatology care.
A traditional review by Kanthraj[14] provides insights into case selection and TC. This article analyzes selection of cases and teledermatology tools, with respect to the various needs of dermatology care. The application of TC in various clinical situations, do’s and don’ts, tools, and guidelines for TC is analyzed.
A comparative study by Shetty et al.[15] analyzes acne scores based on the lesion count and periodic digital imaging. They analyzed 200 cases and provided an image-based scoring system as an alternative to face-to-face examination for acne vulgaris to deliver follow-up care. The newly proposed scoring system can be used for both in TC and in-person examination.
Pangti and Gupta[16] analyze in their original article the scope for TC during the COVID-19 pandemic for inpatient care. This retrospective study from Delhi highlights the importance of TC to offer dermatology care, especially to common clinical conditions. Authors call for the strengthening of TC across the country.
Bhatia et al.[17] from Manipal perform retrospective analysis and establish the role of mobile messenger apps in TC. They demonstrate that WhatsApp can be used to capture and transform images. Authors are of the opinion that patients can be directly involved in this mode of consultation and facilitate TC during the covid-19 pandemic and beyond. In India, dermatologists can practice using mobile messenger apps like WhatsApp. It is easy and convenient for both the patient and the dermatologist. We have to adhere to the guidelines for TC laid by the National Medical Council, Ministry of Family Welfare, and Government of India.
Rosario et al.[18] propose a tinea corporis scoring based on assessment of area,erythema intensityand border visibility. They performed a comparative study to deliver follow-up care using teledermatology consultation between in-person examination and TC from baseline up to two follow-up visits. The proposed scoring system achieves ease of consultation and objective assessment and can be used for both in-person and TC.
Shetty et al.[15] and Andrea et al.[18] have successfully demonstrated follow-up care using a scoring system for acne vulgaris and tinea corporis, respectively by TC.
Anisha et al.[19] report a case of contact dermatitis managed by TC. Serial follow-up care is provided in a geriatric, comorbid with hypertension, and newly detected diabetes in a COVID-19 situation. Authors recommend patient-assisted teledermatology consultation in geriatric and comorbid cases for periodic follow-up care using mobile messenger application (e.g., WhatsApp) with telephonic conversations. This will achieve best patient–physician satisfaction.
In India, the National Medical Commission, in consultation with expert panel, has laid down the guidelines for teledermatology consultation.[20] Health-care providers, telemedicine platform, privacy, patient confidentiality, medical ethics, and reimbursement for TC are addressed.
To conclude, the current special issue can provide readers and update their knowledge in TC. If teledermatology utility is strong in India, then medical care can reach to the rural community. To achieve this in India, we need to focus on the implementation of telemedicine/teledermatology in the undergraduate and postgraduate medical education. From the past 5 years, we had reserved the dissertation works for teledermatology for our postgraduate students and published those works. Interns and postgraduates should be roped for TC. Future research works should focus on identifying the advantages and limitations of individual dermatology conditions for TC as well on the comprehensive implementation in India.
Acknowledgments
The inputs are based on our original works. We are thankful to JSS Academy of Higher Education and Research-JSSAHER, Mysuru India for constant academic encouragement and motivating us to undertake research works on teledermatology/telemedicine consultation and practice.
References
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