Application of teledermatology during the first wave of the COVID-19 pandemic in Hungary

ABSTRACT

During the first wave of the COVID-19 pandemic, outpatient care was limited and it resulted in developing an asynchronous teledermatology system. The aim of our retrospective study was to provide quantitative data the first time about use of teledermatology in the Hungarian healthcare system between March 25 and July 13, 2020. The number of cases, regional distribution and type of diagnoses were analyzed. We also followed up patients who were referred to in-person dermoscopic examination. A total of 10.287 teledermatology consultations were completed at our department. 5.967 (58%) patients were female and 4.320 (42%) patients were male with a mean age of 32.7±22.5 years. 5.967 (58%) cases were from the capital city and its metropolitan area and 32% was from other regions of Hungary. The most common diagnosis was dermatitis, followed by skin infections and pigmented skin lesions. In 1.440 cases, the patient was referred to a dermoscopic examination. Teledermatological examination raised also the diagnosis of malignant skin cancer in 190 patients. Later it was confirmed in 111 cases based on dermoscopic examination. Melanoma was confirmed in 14%, squamous cell carcinoma in 15%, basal cell carcinoma in 63% and other malignancies in 8%. We compared the presumed diagnosis given during the teledermatology consultation with the personal examination. The sensitivity of our system proved to be 87% with a specificity of 86% for diagnosing malignant skin lesions. In addition to the large number of general skin conditions, life-threatening diseases were screened, using teledermatology under the first wave of the COVID- 19 pandemic. The correct diagnosis and treatment of most diseases is a significant achievement. Overall, use of asynchronous teledermatology was an outstanding method during the pandemic period and it has the potential to become an important part of patient care in the future.