Teledermatology Consults in a County Hospital Setting: Retrospective Analysis

In our study, teledermatology consults from PCPs at a county hospital were analyzed to identify common diagnoses that prompted the use of the teledermatology system and which diagnoses required an in-person visit. Diagnosis Cases, n Referred, n (%) Not referred, n Seborrheic keratosis 48 4 (8) 44 Eczema NOSa 30 1 (3) 29 Acne 27 6 (22) 21 Rule out NMSCb,c 28 28 (100) 0 Seborrheic dermatitis 20 2 (10) 18 Actinic keratosis 17 17 (100) 0 Poor photo quality 12 8 (67) 4 Vitiligo 12 4 (33) 8 Banal neoplasm NOS 12 9 (75) 3 Insufficient data 11 7 (64) 4 Wart 11 10 (91) 1 Nevus 10 6 (60) 4 Contact dermatitis 9 3 (33) 6 Alopecia areata 8 8 (100) 0 Rosacea 8 2 (25) 6 Papulosquamous disorder NOS 8 2 (25) 6 Cyst 8 3 (38) 5 Keloid 6 5 (83) 1 Dermatologist unable to make diagnosis 6 4 (67) 2 Onychodystrophy NOS 6 2 (33) 4 Atopic dermatitis 6 0 (0) 6 Lentigo 6 0 (0) 6 Idiopathic guttate hypomelanosis 5 2 (40) 3 Urticaria 5 1 (20) 4 Angioma 5 3 (60) 2 aNOS: not otherwise specified. bNMSC: nonmelanoma skin cancer. cNMSC includes basal cell carcinoma, squamous cell carcinoma, and dermatofibroma sarcoma protuberans. There are several limitations of this study: it did not specifically quantify the severity of disease, it did not follow long-term outcomes of cases managed via teledermatology, and it focused on patients only in a county hospital setting.