Clinical and Laboratory Investigations
Pediatric Teledermatology Consultations: Relationship Between Provided Data and Diagnosis
Article first published online: 26 JUL 2013
© 2013 Wiley Periodicals, Inc.
Volume 30, Issue 5, pages 561–567, September/October 2013
How to Cite
Philp, J. C., Frieden, I. J. and Cordoro, K. M. (2013), Pediatric Teledermatology Consultations: Relationship Between Provided Data and Diagnosis. Pediatric Dermatology, 30: 561–567. doi: 10.1111/pde.12180
- Issue published online: 10 SEP 2013
- Article first published online: 26 JUL 2013
There is a shortage of pediatric dermatologists. Teledermatology has emerged as a tool to facilitate access to dermatologists. Many questions remain regarding how to optimize consultations in order to provide the best diagnosis and management recommendations. The aim of this retrospective cohort study was to categorize the historical data and judge the adequacy of photographs sent by referring providers to our academic pediatric teledermatology practice at the University of California, San Francisco, and to evaluate the relationship of these data to our ability to render a diagnosis. A diagnosis was rendered in 75% of cases. The only historical data associated with receiving a diagnosis was prior treatment (OR 2.01, CI 1.01, 4, p < 0.05). Appropriate image distance from the target was associated with receiving a diagnosis for rashes (OR 2.69, CI 1.07, 6.8, p = 0.04) and growths (OR 4.16, CI 1.04, 16.6, p = 0.04). A lack of diagnosis was significantly associated with a recommendation for referral for biopsy (OR 0.03, CI 0.01, 0.10, p < 0.0001) or for in-person consultation (OR 0.19, CI 0.05, 0.66, p < 0.001). In conclusion, pediatric teledermatologists are able to make a diagnosis most of the time, regardless of historical information provided or image quality. The rate of diagnosis may be improved with the use of standardized templates for historical information. Similarly, photography training could minimize the need for in-person consultation. Specific information regarding prior treatments could also help in providing useful management recommendations.