Leprosy Diagnosed via Teledermatology in a U. S. Urban Academic Health Center Highlights Potential Benefits and a Pitfall of Existing Telemedicine Services.

Purpose: Teledermatology has emerged as an important tool to extend the reach of dermatologists. As utilization of teledermatology services increases, careful attention should be given to the design of the system for consulting dermatologists. Methodology: In this case study, we report how access to a patient's entire medical history in a teledermatology consultation was vital for an accurate diagnosis. Results: This case emphasizes the importance of full access to patients' medical records for improving diagnostic accuracy. We believe that full-access systems will lower the risk of misdiagnosis and will help to maximize the potential of teledermatology.

Acquired pincer nail deformity associated with renal failure.

Pincer nail deformity represents a loss in the normal convex shape of the nail and has been reported in association with various diseases and medications. The authors report a man with end-stage renal disease due to bladder carcinoma who developed pincer nail deformity while on hemodialysis. Previous case reports cite diabetes as a suspected cause of pincer nail development in patients with renal failure. However, the patient described in this case was not diabetic and his nail dystrophy is likely related to arteriovenous fistula placement.