[Successful regional teledermatological and teledermatoscopic triage networking between general practitioners and dermatologists]. / Erfolgreiche regionale teledermatologische und teledermatoskopische Triage-Vernetzung zwischen niedergelassenen Hausärzten und Hautärzten.

BACKGROUND: There is an increasing need by general practitioners (GPs) for consultations regarding skin diseases or skin lesions. Teledermatological and teledermoscopic diagnoses are possible with good results. OBJECTIVES: This descriptive study analyzed whether the increasing need for dermatological consultations could be improved by regional teledermatological and teledermoscopic triage between GPs and dermatologists. MATERIALS AND METHODS: Via an internet platform, six GPs sent images of unclear skin diseases or skin lesions to a dermatology practice (2 dermatologists) over a period of 9 months. Possible triage answers were (1) stay at the GP, (2) urgent consultation at the dermatologist (days), or (3) later (week/months) consultation at the dermatologist, respectively, with the diagnosis and therapeutic suggestions. A feedback (grade 1-6) were given by the dermatologists about the image quality and from the GPs about the appraisal. The dermatologists' appraisals were done independently and were audited by a third dermatologist. RESULTS: The patients' acceptance was 100% and a very good to good image quality was achieved in 94%; 66.3% of patients could stay at their GP and 20.7% of patients should come urgently to the dermatologist. The teletriage decisions of an urgent consultation at the dermatologist were confirmed in 41.5%. The GPs' feedback about the teletriage appraisal received an overall average grade of 1.1. CONCLUSION: Successful regional teledermatological and teledermoscopic triage between GPs and dermatologists is possible. Specifications on data privacy laws must be followed and an appropriate remuneration is preferable.

Self-Collected Gargle Lavage Allows Reliable Detection of SARS-CoV-2 in an Outpatient Setting.

Current procurement of specimens for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection requires trained personnel and dedicated equipment. We compared standard nasopharyngeal swabs with self-collected gargle lavage fluid obtained from 80 mostly symptomatic outpatients. After RNA extraction, RT-PCR to detect SARS-CoV-2 was performed. Qualitative results obtained with the paired samples from individual outpatients were 100% congruent. Therefore, self-collected gargle lavage fluid can serve as a suitable specimen for coronavirus disease 2019 (COVID-19) testing in outpatients. IMPORTANCE The SARS-CoV-2 pandemic still strains health care systems worldwide. While COVID-19 testing is considered an essential pillar in combating this infectious disease, shortages in supplies and trained health care personnel often limit the procurement of patient samples, in particular in outpatient settings. Here, we compared the simple self-collection of gargle lavage fluid with the gold standard nasopharyngeal swab as a specimen for COVID-19 testing. By finding complete congruence of results obtained with paired samples of a sizeable patient cohort, our results strongly support the idea that the painless self-collection of gargle lavage fluid provides a suitable and uncomplicated sample for reliable SARS-CoV-2 detection.