ABSTRACT
Information and Communications Technologies (ICTs), including Teledermatology, have become more relevant during the current Covid-19 pandemic, becoming a strategic instrument for health care due to the restrictions that affect face-To-face care. Material and methods: For better use of Teledermatology, the Sociedad Mexicana de Dermatología y el Colegio Ibero-Latinoamericano de Dermatología (CILAD) issue these guidelines. Three scenarios are determined for the performance of Teledermatology: The sending of medical records, real-Time consultation, and online referral. Results: Teledermatology consultations must be the result of a selection of patients and have to be carried out on private video communication platforms and resources to resolve remote communication problems. Conclusion: The discourse structure and presentation of the participants in this communication modality must be taken into account, resorting to educational tutorials on the use of ICTs and structuring medical digital records. In the video consultation, the patient should be instructed, in the way they appear before the camera, how to handle it, and how to send materials. Specifications are provided for metadata tagging, storage, retrieval, and transmission of images, adapting them to the clinical nature of remote communication. © 2020 Catedra Universitario, Facultad de Medicina. All rights reserved.
ABSTRACT
Objective: Strengthening health protection for patients, as well as for the specialist and their support staff because the COVID-19 pandemic imposes modifications to medical practice. Material and methods: A group of Latin American dermatology experts designated by the Mexican Society of Dermatology and the Ibero-Latin American College of Dermatology (CILAD) issued recommendations for safe dermatological practice within the scenario of the COVID-19 pandemic, regarding basic information, training, and supervision in personal protection, patient history, file management, improvement in non-medical areas related to the control of the consultation room, along with the surveillance of probable cases of infection in patients. Results: The recommendations cover the activities before, during, and after the consultation. Aspects such as office arrangement, work flow control, asepsis, time and care of dermatological areas and the use of digital media are discussed. Conclusions: The design of adequate protocols depends on the specialists understanding the characteristics of the behavior of COVID-19 cases in their location, maintaining contact with health authorities and symptom attention centers, to determine the closing and reopening times of the clinic. © 2020 Catedra Universitario, Facultad de Medicina. All rights reserved.
ABSTRACT
BACKGROUND: Descriptions of cutaneous findings associated with COVID-19 have not been consistently accompanied by histopathology or confirmatory testing for SARS-CoV-2. OBJECTIVE: To describe and classify the cutaneous findings with supporting histopathology of confirmed COVID-19 inpatients. METHODS: We included consecutive inpatients with a confirmed diagnosis of COVID-19 for whom a dermatology consult was requested. A skin biopsy was performed in all cases. Skin findings were classified as being compatible with a cutaneous manifestation of COVID-19 or as representing a distinct clinical entity. RESULTS: Twenty-eight patients were studied in whom thirty-one dermatologic diagnoses were made. Twenty-two of the dermatoses were compatible with a cutaneous manifestation of COVID-19; nine entities were not associated with infection by SARS-CoV-2. The most common COVID-19-associated pattern was an exanthematous presentation. In four patients, a new pattern was observed, characterized by discrete papules with varied histopathological findings including a case of neutrophilic eccrine hidradenitis. No cases of pernio-like lesions were identified. Skin findings not associated with COVID-19 represented 29% of diagnoses and included Malassezia folliculitis, tinea, miliaria and contact dermatitis. LIMITATIONS: There is no gold-standard test to distinguish between viral exanthems and drug reactions. CONCLUSION: A histopathological study is critical before attributing skin findings to a manifestation of COVID-19.