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Pilot Study Using Teledermatology to Manage High-Need Patients With Psoriasis

2010; American Medical Association; Volume: 146; Issue: 2 Linguagem: Inglês

10.1001/archdermatol.2009.375

1538-3652

Julia Frühauf, Gerold Schwantzer, Christina M. Ambros‐Rudolph, Wolfgang Weger, Verena Ahlgrimm‐Siess, Wolfgang Salmhofer, Rainer Hofmann‐Wellenhof,

Nail Diseases and Treatments

PsoriasisP atient empowerment has been found to be a key factor for achieving improved health outcomes in psoriasis. 1 Telemedicine has revolutionized some aspects of health care delivery by transforming relationships between patients and physicians, shifting the power of consultation so that patients may become more informed and assertive. 2However, the greater confidence of dermatologists when making the diagnosis by in-person examinations 3 may have impeded the routine use of teledermatology until now.The present study provides baseline data on the feasibility of teledermatology services for high-need patients with psoriasis, preparing the way for further effectiveness studies.Methods.After approval was granted by the institutional review board at the Medical University of Graz, Austria, and informed written consent was obtained, patients with psoriasis who met the inclusion criteria (men or women, age Ն18 years, eligible for etanercept treatment, 4 and able to use mobile phones) were prospectively enrolled in the 12-week pilot study.Etanercept treatment was administered according to standard protocol. 4 Patients were given and trained on a general packet radio services/universal mobile telecommunications system (GPRS/UMTS)-enabled Smartphone (Nokia 6630; Nokia, Helsinki, Finland) with a 1.3-megapixel camera and special software that integrated both a section for capturing images and a section for the input of historical information, including occurrence of adverse effects or skin lesions in regions inaccessible to the camera (eg, the scalp) or not usually photographed (eg, the genitalia).Patients photographed their skin lesions according to the anatomic areas of Psoriasis Area and Severity Index (PASI) or Palmoplantar PASI (PASI/PPPASI). 5 The data were transmitted through GPRS/UMTS to a Web server at weeks 0, 1, 2, and every 2 weeks thereafter.Treatment instructions were sent via e-mail-to-short message service techniques to the patients' phones within 24 hours.