Tele-dermatology

1. Tele-dermatology A Randomised Controlled Study Using Polaroid Photography to Diagnose Skin Conditions P.Leggett1,D.Gilliland1,M.Cupples1,K.McGlade1, R.Corbett2, M.Stevenson3,K.Steele1 Dept General Practice Queens University1 Dept Dermatology Belfast City Hospital2 Dept Epidemiology Queens University3 Background: Of all GP consultations, 15% are for dermatological conditions-4% of these require referral to a dermatologist.In this study we assess the value of polaroid photography in helping a dermatologist manage patients referred from GPs. Our objective was to determine whether a polaroid photograph(s), with a clinical history, enables a final diagnosis & management plan to be made without the patient having to see the dermatologist face to face. Methodology • Randomised controlled trial • 136 patients (5months-94 years; 55male,81 female) • Recruited from 5 urban general practices • Polaroid photograph(s) taken by referring GP • Standard clinical history sent with photograph(s) Outcomes 136 Patients 65 Control 71 Study Cases Seen by dermatologist 45 26 in the usual way photo-diagnosis photo-diagnosis possible not possible 18 27 did not need needed to Seen in usual to be seen be seen way Of the 27 photo-diagnosis patients who needed to be seen, 20 attended their out-patient appointment and in 19 (95%) of these the face-to-face diagnosis was identical to the photo-diagnosis.In one case the diagnosis was changed from eczema to psoriasis. Conclusions • Polaroid photographs can be used by dermatologists to aid the diagnosis of various dermatological conditions • Polaroid photography offers the potential to reduce the number of attendances at dermatology out-patient clinics • Polaroid photography represents a simple, easy to use and inexpensive method of relaying relevant information to a dermatologist Table summarising the diagnoses in the study and control groups