The majority of skin lesions in pediatric primary care attention could be managed by Teledermatology
The majority of skin lesions in pediatric primary care attention could be managed by Teledermatology
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DOI：
10.1371/journal.pone.0225479
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发表时间：
2019-12-02
期刊：
影响因子：
3.7
通讯作者：
Cordioli, Eduardo
中科院分区：
文献类型：
--
作者：
Bianchi, Mara Giavina;Santos, Andre Pires;Cordioli, Eduardo
背景远程皮肤病学是一种提供准确诊断的工具，随着时间的推移越来越受到重视。它可以用于分流在初级保健的注意，以解决皮肤状况改善访问和减少时间治疗手术，严重甚至致命的diseases.ObjectivesOur的主要目标是评估的比例儿科患者的病变，可以管理使用teledermatology在初级保健的注意。其次，我们要评估的10个最常见的皮肤病，最常见的治疗和转介由teledermatologists活检，在存在皮肤科医生或保持在初级保健attention.MethodsA横断面回顾性研究，涉及6,879个人和10,126病变进行了存储和转发teledermatology在一年内在城市的圣保罗，巴西。如果拍摄的照片质量足够，远程皮肤科医生将诊断，治疗和定位每个病变（如果可能），并选择三个转介选项之一：直接活检，在场的皮肤科医生或保持在初级保健attention.ResultsTeledermatology管理62%的病变保持在初级保健attention，37%被称为皮肤科医生和1%活检，将不在场就诊的平均等待时间缩短了78%。在0-2岁的患者中，与湿疹和良性先天性病变相关的病变占主导地位。从3-12岁，湿疹仍然是一个主要的原因投诉，以及疣和软疣。从13-19岁，痤疮是最重要的问题，其次是特应性皮炎，痣和疣。最常见的治疗是emollient.ConclusionTeletriage解决了63%的病变，而不需要在现场访问，这表明，teledermatology可以管理常见的疾病和优化皮肤科预约最严重的，手术或复杂的皮肤病，减少平均等待时间。
BackgroundTeledermatology is a tool that provides accurate diagnosis and has been gaining more emphasis over time. It can be used for triage in primary care attention to address skin conditions improving access and reducing time to treatment for surgical, severe or even lethal diseases.ObjectivesOur main goal was to evaluate the proportion of pediatric patient's lesions that could be managed using teledermatology in primary care attention. Secondly, we wanted to assess the ten most frequent skin conditions, the most common treatments and the referrals made by the teledermatologists to biopsy, in-presence dermatologist or kept at primary care attention.MethodsA cross-sectional retrospective study involving 6,879 individuals and 10,126 lesions was conducted by store-and-forward teledermatology during one year in the city of Sao Paulo, Brazil. If the photographs taken had enough quality, teledermatologist would diagnose, treat and orient each lesion (if possible), and choose one of three options for referral: direct to biopsy, in-presence dermatologist or kept at primary care attention.ResultsTeledermatology managed 62% of the lesions to be kept at primary care attention, 37% were referred to dermatologists and 1% to biopsy, reducing the mean waiting time for an inpresence visit in 78%. In patients 0-2 years old, lesions related to eczema and benign congenital lesions predominated. From 3-12 years old, eczema was still a major cause of complaint, as well as warts and molluscum. From 13-19 years old, acne was the most significant problem, followed by atopic dermatitis, nevi and warts. The most frequent treatment was emollient.ConclusionTeletriage addressed 63% of the lesions without the need for an in-presence visit, suggesting that teledermatology can manage common diseases and optimize dermatological appointments for the most serious, surgical or complex skin illnesses, reducing the mean waiting time for them.