Teledermatology in an emergency department: benefits and gaps.

BACKGROUND: Teledermatology has provided new avenues through which dermatologists can provide healthcare. Teledermatology was introduced to the Emergency Department (ED) to enable immediate dermatological consult. We aimed to assess the impact of teledermatology on the management of dermatological conditions by emergency medicine physicians and subsequent health resource utilization. METHODS: We conducted a retrospective review of teledermatology referrals from the ED of our tertiary hospital in Singapore from June 2015 to December 2019. The dermatological conditions, the triaging and treatment recommendations were analyzed. Follow-up plans were recorded. RESULTS: Between June 2015 and December 2019, 147 patients were referred from the ED via teledermatology; 11 (7.5%) were admitted, and 136 (92.5%) were recommended to be discharged with a dermatological diagnosis and management plan. If required, a follow-up appointment in the dermatology specialist clinic was arranged. Of the 136 patients who were discharged, 129 (94.9%) patients were provided with outpatient appointment in the dermatology clinic, out of which 110 patients returned for follow-up. 90 (81.8%) patients retained the initial teledermatology diagnoses and 20 (18.2%) patients had their teledermatology diagnoses revised after in-person review. CONCLUSIONS: Teledermatology allows for more efficient triaging of patients with dermatological conditions. Reliability between teledermatology and clinic-based examination is good. Patients may be managed mainly in the outpatient setting with appropriate specialty-directed treatment, return advice, and appropriately-triaged follow-up outpatient appointment.

Dupilumab-associated head and neck dermatitis: Rapid response with abrocitinib treatment.

Development or exacerbation of head and neck dermatitis (HN-D) in association with dupilumab has been reported. Severity of HN-D varies, and may persist even with discontinuation of dupilumab. Development or exacerbation of HN-D is not yet completely understood, and various hypotheses have been made about the possible underlying pathophysiology. To date, there is no established treatment for HN-D in association with dupilumab. We report 2 cases of HN-D occurring following dupilumab treatment, with significant improvement of HN-D following treatment with abrocitinib.