Teledermatology in a Rural Family Practice

Abstract

Background: Telemedicine can provide specialist services at a distance to rural areas where access to such services is limited, especially in developing countries. The objectives of this study are to describe and evaluate a teledermatology service in a rural family practice.

Methods: Internet-based store-and-forward technology was used. Patients were selected who needed a specialist dermatologist's opinion for diagnosis and management. Pictures of skin conditions were taken with a digital camera and forwarded, together with clinical data, via electronic mail (e-mail) to specialist dermatologists at either of three distant academic centres. Digital pictures of skin biopsies were also forwarded from the regional pathology laboratory. Results were received via e-mail.

Results: Over a twenty-one month period, fifty-two patients had teledermatology consultations. Picture quality was adequate for evaluation in all cases. The family practitioner's provisional diagnosis, compared to the teledermatologists, was correct in 28 (57%) of 49 cases where a definite diagnosis was made. Six patients needed referral to a dermatology clinic. The most common diagnoses (number) were rinea (8), acquired immune-deficiency syndrome associated papulopruritic eruption (3), photosensitive dermatitis (3) scleroderma or morphea (3), pryriasis rosea (2), psoriasis (2) and systemic lupus erythematosis (2).

Conclusion: Most patients with dermatology problems in rural family practice can be managed by means of store-and-forward teledermatology.