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1.
Cutis ; 109(4): 211-217, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1879659

ABSTRACT

The direct-to-consumer (DTC) telemedicine industry, including teledermatology, has seen rapid expansion in recent years, partly because of the COVID-19 pandemic. The shortage of dermatologists and the visual nature of dermatologic conditions attracted DTC companies to dermatology. As more patients continue to seek medical consultations and prescription medications from these for-profit companies, we must approach their growth with healthy skepticism. Shortcomings of DTC teledermatology include concerns about conflicts of interest (COIs), overdiagnosis, and overprescribing. Although DTC teledermatology is certainly here to stay, an appropriate understanding of this industry will allow dermatologists to advise patients and advocate for best practices.


Subject(s)
COVID-19 , Dermatology , Skin Diseases , Telemedicine , Humans , Pandemics , Skin Diseases/diagnosis , Skin Diseases/therapy
2.
Stud Health Technol Inform ; 290: 465-468, 2022 Jun 06.
Article in English | MEDLINE | ID: covidwho-1879410

ABSTRACT

The aim of this study was to assess the patient experience with teledermatology among new versus existing clinic patients in the context of the rapid practice shift to teledermatology during the COVID-19 pandemic. We analyzed survey responses from 184 teledermatology patients seen during COVID-19 at a major Southeastern medical center from May 13th to June 5th 2020. Overall patient-reported satisfaction with teledermatology was high with the majority of respondents rating their overall satisfaction as excellent (68%) or very good (18%). As teledermatology experiences wider adoption with the COVID-19 pandemic, it is essential to examine patient experience and satisfaction with teledermatology.


Subject(s)
COVID-19 , Dermatology , Skin Diseases , Telemedicine , Humans , Pandemics , Patient Satisfaction , Skin Diseases/diagnosis , Skin Diseases/therapy
4.
Hautarzt ; 73(4): 291-297, 2022 Apr.
Article in German | MEDLINE | ID: covidwho-1733959

ABSTRACT

BACKGROUND: The persistent global pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can manifest on the skin in addition to the already known organ systems. Various clinical patterns of skin manifestations associated with coronavirus disease 2019 (COVID-19) have been described. In view of the associated morbidity and mortality, knowledge of cutaneous manifestations in the setting of COVID-19 may be helpful in early detection, risk stratification, diagnosis and treatment. Thus, we provide a summary of the various dermatologic findings associated with COVID-19, including clinical presentation, current pathophysiological concepts, and management, to support early diagnosis and treatment. GOAL: The current literature regarding skin lesions associated with COVID-19 and the most important aspects are analyzed. MATERIALS AND METHODS: A literature search was performed in PubMed and Medline databases until February 28, 2021. RESULTS AND CONCLUSION: The classification of skin manifestations in the context of SARS-CoV­2 infection according to clinical dermatological patterns can help to identify patients with increased risk at an early stage and to treat them adequately to counteract a possibly more severe course of the disease as it occurs, e.g., in livedo. Thus, knowledge of the pathophysiological mechanisms can improve management of the disease and support possible countermeasures in coping with the disease.


Subject(s)
COVID-19 , Skin Diseases , Humans , Pandemics , SARS-CoV-2 , Skin/pathology , Skin Diseases/diagnosis , Skin Diseases/etiology , Skin Diseases/therapy
9.
JAMA Dermatol ; 157(3): 330-337, 2021 03 01.
Article in English | MEDLINE | ID: covidwho-1453488

ABSTRACT

Importance: Shared decision-making (SDM) can improve the quality of care for patients. The extent to which this tool has been used and the evidence supporting its use in dermatology have not been systematically examined. Objective: To perform a scoping review of the literature regarding SDM in dermatology. Evidence Review: Searches of Ovid MEDLINE, PsycINFO, PsycARTICLES, Sciverse Scopus, and EBM Reviews were conduced on July 11, 2019, and March 6, 2020. There were no limits on date, type of article, language, or subject for the initial search. A total of 1673 titles and abstracts were screened by 2 independent reviewers in the Covidence mixed-methods platform. Forty-one full-text studies were assessed for eligibility. For inclusion, articles needed to include a dermatologic diagnosis as well as discussion of SDM or patient decision aids. Two independent reviewers screened 29 full-text articles for inclusion and extracted qualitative data using a set of 26 predefined codes. Qualitative coding was applied to excerpts to categorize the article, define and describe advantages and disadvantages of SDM, understand patient and physician requests for SDM, and discuss methods of implementation. Findings: Despite a small number of articles on SDM (n = 29) in dermatology, the selected literature provided consistent messages regarding the importance of SDM for dermatology and a number of strategies and tools for implementation. Medical dermatology was the most common subspecialty studied, with melanoma, psoriasis, and connective tissue diseases most examined. Only 5 publications introduced SDM tools specifically for dermatologic conditions; of these, only 2 tools were validated. Barriers to implementation that were cited included time and a lack of training for clinicians, although the literature also provided potential solutions to these issues. All articles emphasized the value of SDM for both patients and physicians. Conclusions and Relevance: The literature regarding SDM in dermatology consistently suggests that it is a useful tool for providing patient-centered care. Established tools have been proposed since 2012. More research is needed to implement better practices, especially in dermatologic subspecialties. However, there are substantial suggestions from the literature for strategies and tools with which to begin a shared decision-making practice.


Subject(s)
Decision Making, Shared , Dermatology/standards , Quality of Health Care , Humans , Patient-Centered Care/standards , Skin Diseases/therapy
11.
Dermatol Clin ; 39(4): 639-651, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1437429

ABSTRACT

Coronavirus disease 2019 (COVID-19) brought the world to its knees. As each nation grappled with launching an effective response while simultaneously minimizing repercussions on health care systems, economies, and societies, the medical and scientific landscape shifted forever. In particular, COVID-19 has challenged and transformed the field of dermatology and the way we practice. In this article, dermatologists from 11 countries share insights gained from local experience. These global perspectives will help provide a better framework for delivering quality dermatologic care and understanding how the field has evolved during this medical crisis.


Subject(s)
COVID-19/epidemiology , Clinical Decision-Making/methods , Dermatology/organization & administration , Health Services Accessibility/organization & administration , Skin Diseases/therapy , Academic Medical Centers , COVID-19/prevention & control , Humans , Interdisciplinary Communication
12.
Viruses ; 13(10)2021 09 24.
Article in English | MEDLINE | ID: covidwho-1438744

ABSTRACT

Coronavirus disease 2019 (COVID-19) is a multisystem disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), that primarily causes respiratory symptoms. However, an increasing number of cutaneous manifestations associated with this disease have been reported. The aim of this study is to analyze the scientific literature on cutaneous manifestations associated with SARS-CoV-2 by means of a narrative literature review until June 2021. The search was conducted in the following electronic databases: Medline (PubMed), SciELO, and Cochrane Library Plus. The most common cutaneous manifestations in patients with COVID-19 are vesicular eruptions, petechial/purpuric rashes, acral lesions, liveoid lesions, urticarial rash, and maculopapular-erythematous rash. These manifestations may be the first presenting symptoms of SARS-CoV-2 infection, as is the case with acral lesions, vesicular eruptions, and urticaria. In relation to severity, the presence of liveoid lesions may be associated with a more severe course of the disease. Treatment used for dermatological lesions includes therapy with anticoagulants, corticosteroids, and antihistamines. Knowledge of the dermatologic manifestations associated with SARS-CoV-2 contributes to the diagnosis of COVID-19 in patients with skin lesions associated with respiratory symptoms or in asymptomatic patients. In addition, understanding the dermatologic lesions associated with COVID-19 could be useful to establish a personalized care plan.


Subject(s)
COVID-19/pathology , Skin Diseases/pathology , Skin/pathology , COVID-19/metabolism , Exanthema/pathology , Exanthema/therapy , Exanthema/virology , Humans , SARS-CoV-2/pathogenicity , Skin/virology , Skin Diseases/therapy , Skin Diseases/virology , Skin Physiological Phenomena , Urticaria/pathology , Urticaria/therapy , Urticaria/virology
13.
J Cutan Med Surg ; 26(2): 135-142, 2022.
Article in English | MEDLINE | ID: covidwho-1435194

ABSTRACT

BACKGROUND: During the 2019 Coronavirus (COVID-19) pandemic, the Division of Dermatology, University of Ottawa, adapted pre-existing local healthcare infrastructures to provide increased provider-to-provider teledermatology services as well as integrated teledermatology into the dermatology residency training program. OBJECTIVES: (1) To assess the differences in utilization of provider-to-provider teledermatology services before and during the COVID-19 pandemic; and (2) to assess dermatology resident and faculty experiences with the integration of teledermatology into dermatology residency training at the University of Ottawa. METHODS: We conducted a cross-sectional analysis comparing provider-to-provider teledermatology consults submitted to dermatologists from April 2019 to October 2019 pre-pandemic with the same period during the pandemic in 2020. Two different questionnaires were also disseminated to the dermatology residents and faculty at our institution inquiring about their perspectives on teledermatology, education, and practice. RESULTS: The number of dermatologists completing consults, the number of providers submitting a case to Dermatology, and the number of consults initiated all increased during the pandemic period. Ninety-one percent of residents agreed that eConsults and teledermatology enhanced their residency education, enabled continuation of training during the pandemic, and that eConsult-based training should be incorporated into the curriculum. Ninety-six percent of staff incorporated a virtual dermatology practice model, and one-third used teledermatology with residents during the pandemic. Most staff felt there was value in providing virtual visits in some capacity during the pandemic. CONCLUSIONS: Our study confirms that the use of teledermatology services continues to increase accessibility during the pandemic. Teledermatology enhances the education and training of residents and will be incorporated into dermatology residency programs.


Subject(s)
COVID-19 , Dermatology , Internship and Residency , Skin Diseases , Telemedicine , COVID-19/epidemiology , Cross-Sectional Studies , Dermatology/education , Humans , Pandemics , Skin Diseases/diagnosis , Skin Diseases/therapy
14.
J Med Virol ; 93(10): 5756-5767, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1432444

ABSTRACT

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has become a significant health problem globally. The virus has spread widely and become a global pandemic. The pathophysiology for SARS-CoV-2 has not been explained clearly. It has been associated with several multiorgan symptoms, among which its dermatological manifestations are of great interest. Primarily, there has been no report of skin features among COVID-19 patients. Nevertheless, recently there have been several reports regarding COVID-19 patients who presented with cutaneous manifestations. In the current review, we focus on the various cutaneous manifestations of COVID-19 infection.


Subject(s)
COVID-19/complications , Skin Diseases/etiology , COVID-19/drug therapy , Dermatitis, Occupational/diagnosis , Dermatitis, Occupational/etiology , Dermatitis, Occupational/pathology , Dermatitis, Occupational/therapy , Diagnosis, Differential , Drug Eruptions/diagnosis , Drug Eruptions/etiology , Drug Eruptions/pathology , Drug Eruptions/therapy , Humans , Personal Protective Equipment/adverse effects , SARS-CoV-2 , Skin Diseases/diagnosis , Skin Diseases/pathology , Skin Diseases/therapy
16.
Dermatol Clin ; 39(4): 587-597, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1343177

ABSTRACT

The impact of the COVID-19 pandemic on dermatology practice cannot be overstated. At its peak, the pandemic resulted in the temporary closure of ambulatory sites as resources were reallocated towards pandemic response efforts. Many outpatient clinics have since reopened and are beginning to experience a semblance of pre-pandemic routine, albeit with restrictions in place. We provide an overview of how COVID-19 has affected dermatology practice globally beginning with the rise of teledermatology. A summary of expert recommendations that shape the "new normal" in various domains of dermatology practice, namely, dermatology consultation, procedural dermatology, and phototherapy, is also provided.


Subject(s)
Ambulatory Care Facilities/trends , Dermatology/standards , Primary Health Care/trends , Skin Diseases/therapy , Telemedicine/trends , COVID-19/epidemiology , Dermatology/trends , Health Services Accessibility/trends , Humans , Office Visits/trends , Skin Diseases/epidemiology
19.
Dermatol Clin ; 39(4): 609-618, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1330740

ABSTRACT

COVID-19 has created challenges across medicine, including in medical education, with deeply rooted impacts in the dermatology residency experience. Its effects are both acute and chronic, including: shifts to virtual education and conferences, skewed clinical experiences, negatively impacted wellness, and uncertainty in the future. As educators and mentors, it is important to recognize and address these issues so that we may remain transparent, adaptable, and engaged as we continue to build a better tomorrow for our resident trainees.


Subject(s)
COVID-19/epidemiology , Dermatology/education , Fellowships and Scholarships/trends , Internship and Residency/trends , Patient Care Management/trends , Skin Diseases/therapy , Attitude of Health Personnel , Humans , Social Perception
20.
J Med Virol ; 93(10): 5756-5767, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1303274

ABSTRACT

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has become a significant health problem globally. The virus has spread widely and become a global pandemic. The pathophysiology for SARS-CoV-2 has not been explained clearly. It has been associated with several multiorgan symptoms, among which its dermatological manifestations are of great interest. Primarily, there has been no report of skin features among COVID-19 patients. Nevertheless, recently there have been several reports regarding COVID-19 patients who presented with cutaneous manifestations. In the current review, we focus on the various cutaneous manifestations of COVID-19 infection.


Subject(s)
COVID-19/complications , Skin Diseases/etiology , COVID-19/drug therapy , Dermatitis, Occupational/diagnosis , Dermatitis, Occupational/etiology , Dermatitis, Occupational/pathology , Dermatitis, Occupational/therapy , Diagnosis, Differential , Drug Eruptions/diagnosis , Drug Eruptions/etiology , Drug Eruptions/pathology , Drug Eruptions/therapy , Humans , Personal Protective Equipment/adverse effects , SARS-CoV-2 , Skin Diseases/diagnosis , Skin Diseases/pathology , Skin Diseases/therapy
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