Estudio piloto de la teledermatología directa durante el estado de alarma por la pandemia COVID-19 en un área sanitaria de Madrid (Estudio EVIDE-19) / Direct-to-Patient Teledermatology During COVID-19 Lockdown in a Health District in Madrid, Spain: The EVIDE-19 Pilot Study

ANTECEDENTES: Como consecuencia de la pandemia por la COVID-19 cesó la actividad dermatológica asistencial, por lo que iniciamos un estudio para evaluar la utilidad de la teledermatología (TD) directa entre paciente y dermatólogo a través de una App. El objetivo fue evaluar el impacto de esta herramienta para evitar consultas presenciales, así como describir los principales diagnósticos y la satisfacción de pacientes y médicos. MATERIAL Y MÉTODO: Estudio descriptivo prospectivo. Se incluyen pacientes nuevos que cumplen criterios de inclusión. Se realizó un análisis descriptivo de todas las variables mediante el programa estadístico SPSS. RESULTADOS: De los 1.497 pacientes que aceptaron participar el 25% (n = 374) enviaron una consulta virtual con imagen. De entre ellos el 17% (n = 64) fueron dados de alta de forma directa para control por atención primaria. En un 85% (n=318) de los pacientes se logra evitar la consulta presencial durante al menos 3 meses. Se emitió un diagnóstico en el 87,1% (n = 325) de los pacientes, siendo la confianza en el diagnóstico ≥ 7/10 en el 77,5% (n = 290). La calidad de la imagen fue suficiente en el 52,1%. La satisfacción del paciente fue de 4,5/5. Once de 16 dermatólogos consideraron la TD útil globalmente. La afección más frecuente fue la inflamatoria y melanocítica, siendo los diagnósticos más habituales nevus, acné y eccema. DISCUSIÓN:La TD directa asíncrona es una herramienta eficaz para valorar pacientes nuevos, con un alto grado de satisfacción para médicos y pacientes. El desarrollo de un sistema de TD eficiente implica la integración de la imagen digital en los sistemas de información médicos

BACKGROUND: Dermatologic care was halted because of the coronavirus disease 2019 pandemic, prompting us to study the usefulness of direct-to-patient teledermatology via a mobile application. We aimed to evaluate the service as a tool for avoiding face-to-face consultations, describe the main conditions diagnosed, and assess levels of patient and physician satisfaction. MATERIAL AND METHOD: Prospective descriptive study of new patients who met the inclusion criteria. Descriptive statistics for all variables were analyzed with SPSS. RESULTS: Of the 1,497 patients who agreed to participate in the study, 25% (n = 374) sent an image to a consultant dermatologist through the mobile application. Sixty-four patients (17%) were discharged directly and referred to primary care for follow-up. A face-to-face consultation was avoided for at least 3 months in 85% of patients (n = 318); 87.1% (n = 325) received a diagnosis and the dermatologist's level of confidence in this diagnosis was 7 or higher in 77.5% of cases (n = 290). The quality of the images sent was considered sufficient in 52.1% of cases. Patients rated their satisfaction with a score of 4.5 out of 5. Eleven of the 16 dermatologists rated their satisfaction as good overall. The most common conditions were inflammatory and melanocytic lesions. The main diagnoses were nevi, acne, and eczema. DISCUSSION: Direct-to-patient store-and-forward teledermatology is an effective means of evaluating new patients. Both clinicians and patients expressed high levels of satisfaction with the service. Systems enabling the addition of digital images to patient records are necessary to ensure the efficiency of teledermatology

Direct-to-Patient Teledermatology During COVID-19 Lockdown in a Health District in Madrid, Spain: The EVIDE-19 Pilot Study. / Estudio piloto de la teledermatología directa durante el estado de alarma por la pandemia COVID-19 en un área sanitaria de Madrid (Estudio EVIDE-19).

BACKGROUND: Dermatologic care was halted because of the coronavirus disease 2019 pandemic, prompting us to study the usefulness of direct-to-patient teledermatology via a mobile application. We aimed to evaluate the service as a tool for avoiding face-to-face consultations, describe the main conditions diagnosed, and assess levels of patient and physician satisfaction. MATERIAL AND METHOD: Prospective descriptive study of new patients who met the inclusion criteria. Descriptive statistics for all variables were analyzed with SPSS. RESULTS: Of the 1,497 patients who agreed to participate in the study, 25% (n=374) sent an image to a consultant dermatologist through the mobile application. Sixty-four patients (17%) were discharged directly and referred to primary care for follow-up. A face-to-face consultation was avoided for at least 3 months in 85% of patients (n=318); 87.1% (n=325) received a diagnosis and the dermatologist's level of confidence in this diagnosis was 7 or higher in 77.5% of cases (n=290). The quality of the images sent was considered sufficient in 52.1% of cases. Patients rated their satisfaction with a score of 4.5 out of 5. Eleven of the 16 dermatologists rated their satisfaction as good overall. The most common conditions were inflammatory and melanocytic lesions. The main diagnoses were nevi, acne, and eczema. DISCUSSION: Direct-to-patient store-and-forward teledermatology is an effective means of evaluating new patients. Both clinicians and patients expressed high levels of satisfaction with the service. Systems enabling the addition of digital images to patient records are necessary to ensure the efficiency of teledermatology.

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Crioterapia en zonas anatómicas de difícil acceso / Cryotherapy in Anatomically Difficult Areas

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Electroquimioterapia con bleomicina intravenosa en el tratamiento del carcinoma de células de Merkel irresecable / Electrochemotherapy With Intravenous Bleomycin in the Treatment of Unresectable Merkel Cell Carcinoma

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Verrugas genitales, linfangioma y tratamiento con imiquimod / Genital Warts, Lymphangioma, and Treatment with Imiquimod

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Nódulo pétreo subcutáneo / Stony-hard Subcutaneous Nodule

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Toma de muestras y examen directo en dermatomicosis / Sample Taking and Direct Examination in Dermatomycoses

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