Cited by 48Telemedicine and Telehealth ImplementationCutaneous Melanoma Detection and ManagementDermatology and Skin Diseases

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

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Giavina Bianchi, Mara, Santos, Andre Pires, Cordioli, Eduardo·2019·PLOS ONE

Abstract

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.

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  • Post-COVID-19, reported pediatric teledermatology consult diagnoses included atopic dermatitis, Gianotti Crosti Syndrome, intertrigo, photodermatitis, acne, adnexal disorders, alopecia, IH, skin infections/infestations, molluscum contagiosum, verruca vulgaris, melanocytic nevi, pigmentary disorders, and psoriasis.

    “Post–COVID-19, reported pediatric teledermatology consult diagnoses included atopic dermatitis, Gianotti Crosti Syndrome, intertrigo, photodermatitis, acne, adnexal disorders, alopecia, IH, skin infections/infestations, molluscum contagiosum, verruca vulgaris, melanocytic nevi, pigmentary disorders, and psoriasis [2,11].”

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  1. [3]Ranjani P, Carla B, Toni M. Teledermatology initiative to increase access for community helath center patients. new england journal of medicine catalyst [Internet]. 2019 Available from: https://catalyst.nejm.org/teledermatology-access-community-health/.

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Authors
Giavina Bianchi, M., Santos, A. P., & Cordioli, E.
Affiliations
Hospital Israelita Albert Einstein (BR)
Venue
PLOS ONE
Published
2019-12-02
Volume
14
Issue
12
Pages
e0225479
ISSN
1932-6203 (ISSN-L)
OpenAlex
W2993265301
Cited by
48
References
20
Citations by year
2026: 3 · 2025: 6 · 2024: 8 · 2023: 7 · 2022: 7 · 2021: 10 · 2020: 5 · 2013: 2
FWCI
5.07
Type
journal article
Language
en
Open access
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
  • Health Sciences › Medicine › Oncology › Cutaneous Melanoma Detection and Management
  • Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
Keywords
teledermatology, store-and-forward telemedicine, pediatric skin lesion, teletriage, primary care, atopic dermatitis, acne, warts, molluscum contagiosum, nevi, emollients, dermatology referral, waiting time reduction, access to dermatological care
MeSH terms
Adolescent, Biopsy, Brazil, Child, Child, Preschool, Cross-Sectional Studies, Dermatology, Emollients, Female, Humans, Infant, Infant, Newborn, Male, Primary Health Care, Referral and Consultation, Retrospective Studies, Skin, Skin Diseases, Triage, Telemedicine, Young Adult

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