Pediatric teledermatology: Observations based on 429 consults

Background: Store-and-forward teledermatology is an emerging means of access for patients with skin disease lacking direct access to dermatologists. Objectives: We sought to examine the patient demographics, diagnostic concordance, and treatment patterns in teledermatology for patients younger than 13 years. Methods: We conducted a descriptive retrospective cohort study involving 429 patients. Results: Diagnoses were concordant in 48% of cases, partially concordant in 10%, and discordant in 42%. Management recommendations were concordant in 28% of cases, partially concordant in 36%, and discordant in 36%. Primary care providers tended to underuse topical steroids and overuse topical antifungals and systemic antibiotics. Only 1.4% and 6.0% of patients required repeated teledermatology consultation and in-person dermatology consultation, respectively. Limitations: Limitations were the inability to generalize the data from the population studied and the chances of error and bias in teledermatology diagnoses. Conclusions: Store-and-forward teledermatology can improve diagnostic and therapeutic care for skin disease in children who lack direct access to dermatologists. (J Am Acad Dermatol 2010;62:61-6.)