RESUMO
BACKGROUND: The Covid-19 Pandemic prompted the widespread implementation of telemedicine across healthcare. OBJECTIVE: To analyze telemedicine adoption by Mohs Micrographic surgeons (MMS) during the COVID-19 pandemic; to analyze the attitudes and perceived barriers to its long-term continuation by MMS practices. METHODS AND MATERIALS: An online multiple-choice survey was distributed to members of the American College of Mohs Surgeons. RESULTS: 86.1% of surveyed Mohs surgeons initiated telemedicine during the pandemic surge. The most common uses for telemedicine amongst respondents were post-surgery management (77.4%), "spot checks" (60.9%), and surgical consultations (59.1%). 73.1% report patients were receptive to telemedicine. 68.6% believe that telemedicine has a place in dermatologic surgery; 49.5% plan to incorporate telemedicine into their surgical practices long-term. Physical exam limitations, fitting telemedicine into practice workflow, and patient reception/patient training were viewed as the most significant barriers to long-term implementation. CONCLUSIONS: While valuable use cases for telemedicine were identified with most Mohs surgeon respondents feeling that telemedicine has a place in their practices, there is uncertainty in how to implement telemedicine into the dermatologic surgery practice workflow.
Assuntos
COVID-19 , Dermatologia/estatística & dados numéricos , Cirurgia de Mohs , Telemedicina/estatística & dados numéricos , Atitude do Pessoal de Saúde , COVID-19/prevenção & controle , Dermatologia/organização & administração , Humanos , Educação de Pacientes como Assunto , Satisfação do Paciente , Exame Físico , Projetos Piloto , Cuidados Pós-Operatórios , Encaminhamento e Consulta , SARS-CoV-2 , Inquéritos e Questionários , Fluxo de TrabalhoRESUMO
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.
Assuntos
COVID-19/epidemiologia , Tomada de Decisão Clínica/métodos , Dermatologia/organização & administração , Acessibilidade aos Serviços de Saúde/organização & administração , Dermatopatias/terapia , Centros Médicos Acadêmicos , COVID-19/prevenção & controle , Humanos , Comunicação InterdisciplinarAssuntos
Antineoplásicos/administração & dosagem , Dermatologia/tendências , Linfoma Cutâneo de Células T/tratamento farmacológico , Neoplasias Cutâneas/tratamento farmacológico , Telemedicina/tendências , Administração Cutânea , Biópsia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis/normas , Dermatologia/organização & administração , Dermatologia/normas , Humanos , Linfoma Cutâneo de Células T/diagnóstico , Linfoma Cutâneo de Células T/patologia , Pandemias/prevenção & controle , Autoadministração , Pele/diagnóstico por imagem , Pele/patologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/patologia , Telemedicina/organização & administração , Telemedicina/normas , Estados Unidos/epidemiologiaAssuntos
COVID-19/epidemiologia , Conservação dos Recursos Naturais/métodos , Dermatologia/métodos , Telemedicina/métodos , COVID-19/diagnóstico , COVID-19/virologia , Pegada de Carbono/estatística & dados numéricos , Conservação dos Recursos Naturais/estatística & dados numéricos , Estudos Transversais , Atenção à Saúde/tendências , Dermatologia/organização & administração , Humanos , Irlanda/epidemiologia , SARS-CoV-2/genética , Software , Telemedicina/estatística & dados numéricosAssuntos
COVID-19/patologia , Dermatologia/organização & administração , Linhas Diretas/estatística & dados numéricos , Dermatopatias/patologia , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/psicologia , Fundações/organização & administração , Acessibilidade aos Serviços de Saúde/tendências , Linhas Diretas/tendências , Humanos , Irlanda/epidemiologia , Papel do Profissional de Enfermagem , SARS-CoV-2/genética , Dermatopatias/diagnóstico , Dermatopatias/epidemiologiaRESUMO
The accelerated implementation and use of teledermatology during the coronavirus disease 2019 pandemic has met with successes and challenges. This review explores how telemedicine was used in dermatology before the pandemic, the regulatory adaptions made in response to the pandemic, and the effectiveness of the rapid implementation of teledermatology during the coronavirus disease 2019 pandemic, and, finally, how teledermatology has expanded in response to the pandemic. This review examines lessons learned and how teledermatology's reliance on digital technologies might paradoxically exacerbate health care disparities, and finally, considers the future outlook.
Assuntos
COVID-19/epidemiologia , Encaminhamento e Consulta/estatística & dados numéricos , Dermatopatias/diagnóstico , Dermatopatias/terapia , Telemedicina/estatística & dados numéricos , Dermatologia/organização & administração , Humanos , Consulta Remota/estatística & dados numéricos , Índice de Gravidade de DoençaAssuntos
Infecções por Coronavirus/epidemiologia , Dermatologia/organização & administração , Pandemias , Pneumonia Viral/epidemiologia , Betacoronavirus , COVID-19 , Infecções por Coronavirus/transmissão , Dermatologia/métodos , Transmissão de Doença Infecciosa/prevenção & controle , Humanos , Pneumonia Viral/transmissão , Consulta Remota , SARS-CoV-2Assuntos
Infecções por Coronavirus/epidemiologia , Dermatologistas/organização & administração , Médicos/organização & administração , Pneumonia Viral/epidemiologia , COVID-19 , Infecções por Coronavirus/terapia , Dermatologia/organização & administração , Humanos , Cidade de Nova Iorque/epidemiologia , Pandemias , Pneumonia Viral/terapia , Estados Unidos/epidemiologiaRESUMO
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is implicated in the ongoing pandemic across the globe since December 2019. It was first notified by China from Wuhan on 31 December 2020 and transmission to healthcare workers was first reported on 20 January 2020. Human-to-human transmission is mainly by droplet infection. At present no effective vaccine is available. Our speciality needs to collectively address the urgent issue of risk of transmission in dermatology practice. A case series of Coronavirus Disease 2019 (COVID-19) from Wuhan described that 41.3% of their patients may have acquired the infection from the hospital. Of all the infected health care workers, 77.5% worked in general wards and departments. These data highlight the significant risk of nosocomial transmission of COVID-19 and also the higher risk in general wards and departments compared to the emergency room or intensive care unit. Dermatology patients are generally seen in clinics and in outpatient departments in hospitals. Patients wait together in the waiting area, intermingle and then are seen by the physician in their chamber. This can cause transmission of the pathogen among patients and from patient to physician. Social distancing, hand hygiene and the use of personal protective equipment are important for preventing the spread of infection and dermatology practices also have to incorporate these aspects. Telemedicine is becoming an important tool for the management of dermatology patients in these times. At-risk patients in dermatology also need to be given priority care. Protocols for the use of immunosuppressants and biologics in dermatology during the pandemic are being developed.
Assuntos
COVID-19/prevenção & controle , Infecção Hospitalar/prevenção & controle , Dermatologia/organização & administração , Dermatopatias/terapia , Assistência Ambulatorial/métodos , Assistência Ambulatorial/organização & administração , Produtos Biológicos/uso terapêutico , COVID-19/transmissão , Infecção Hospitalar/transmissão , Humanos , Imunossupressores/uso terapêutico , Índia , Fatores de Risco , SARS-CoV-2 , Dermatopatias/complicações , Dermatopatias/diagnóstico , Telemedicina/legislação & jurisprudência , Vacinação , Salas de EsperaRESUMO
BACKGROUND: Since December 2019, the global population has been experiencing an unprecedented challenge due to Corona virus disease (COVID-19). A pandemic was declared by the World Health Organization on March 11th 2020, with an escalation of new cases worldwide. Dermatology units experienced a reorganization of regular activity, also providing clinical diagnosis and medical assistance to COVID-19-positive patients who developed cutaneous manifestations. OBJECTIVE: To evaluate the impact of the COVID-19 pandemic on Italian dermatologic clinical practice. MATERIALS & METHODS: This was a prospective online survey, consisting of a questionnaire with 35 multiple-choice questions uploaded on the website of the Italian Society of Dermatology and Venereology - SIDeMaST. RESULTS: A total of 136 dermatologists, 78 women (57%) and 58 men (43%), participated in the survey. The mean age was 58 ± 14 years. In total, 60% of participants reported an impact of the pandemic on their practice, in most cases consisting of a remarkable reduction in routine clinical activity (58%). Concern regarding possible infection was evaluated with a score ranging from 0 (no concern) to 5 (extremely concerned): the fear of becoming infected was high (≥3 in 40%), as was the fear of infecting families, colleagues or patients (≥3 points in 45%). CONCLUSION: The COVID-19 pandemic is having a strong impact on dermatology practice in Italy. The identification of critical points may help scientific societies to improve the clinical scenario and create specific strategies to overcome the emergency.
Assuntos
COVID-19/epidemiologia , Dermatologia/organização & administração , Padrões de Prática Médica , COVID-19/transmissão , Dermatologistas/psicologia , Medo , Feminino , Pesquisas sobre Atenção à Saúde , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Prospectivos , Fatores de Risco , SARS-CoV-2 , Dermatopatias Virais/diagnóstico , Dermatopatias Virais/terapiaAssuntos
COVID-19 , Dermatologia/métodos , Fotografação , Encaminhamento e Consulta , Dermatopatias/diagnóstico , Dermatopatias/terapia , Telemedicina/métodos , Triagem/métodos , Acne Vulgar/diagnóstico , Acne Vulgar/terapia , Alopecia/diagnóstico , Alopecia/terapia , Atenção à Saúde , Dermatologia/organização & administração , Eczema/diagnóstico , Eczema/terapia , Humanos , Intertrigo/diagnóstico , Intertrigo/terapia , Atenção Primária à Saúde , Psoríase/diagnóstico , Psoríase/terapia , SARS-CoV-2 , Dermatopatias Infecciosas/diagnóstico , Dermatopatias Infecciosas/terapia , Telemedicina/organização & administração , Telefone , Reino Unido , Urticária/diagnóstico , Urticária/terapiaAssuntos
COVID-19/epidemiologia , Dermatite de Contato/prevenção & controle , Dermatologia/organização & administração , Telemedicina/organização & administração , Acessibilidade aos Serviços de Saúde , Humanos , Visita a Consultório Médico/estatística & dados numéricos , Atenção Primária à Saúde/organização & administração , Dermatopatias/prevenção & controleAssuntos
COVID-19/patologia , Dermatologia/organização & administração , Síndrome de Stevens-Johnson/tratamento farmacológico , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/virologia , Ensaios Clínicos como Assunto , Dermatologia/estatística & dados numéricos , Pesquisa sobre Serviços de Saúde/legislação & jurisprudência , Humanos , Jornalismo Médico , Prevalência , Editoração/estatística & dados numéricos , SARS-CoV-2/genética , Medicina Estatal/organização & administração , Síndrome de Stevens-Johnson/epidemiologia , Reino Unido/epidemiologiaRESUMO
The world has changed dramatically since the COVID-19 pandemic began. In addition to our social, occupational, and personal lives, the new coronavirus also poses novel challenges for all physicians, including dermatologists. Several skin conditions have emerged, mainly as a result of prolonged contact with personal protective equipment and excessive personal hygiene. Pressure injury, contact dermatitis, itch, pressure urticaria, and exacerbation of preexisting skin diseases, including seborrheic dermatitis and acne, have been described. We have focused on the dermatologic aspects of the COVID-19 infection so that dermatologists are aware of the skin complications and preventive measures can be taken in the COVID-19 pandemic.