ABSTRACT
Background: The COVID-19 pandemic has shifted healthcare from physical in-person patient visits to teleconsultations in order to curtail the spread of this virus. Dermatology, being a visual science, lends itself amenably to teleconsultation. Objective: This study was performed to assess the basic dermatological diseases which are more easily diagnosable and managed through teleconsultation, distinguishing them from diseases for which a face-to-face consultation may be a better option and to delineate the factors affecting the image quality which is the cornerstone of a teledermatology consultation. Methods: A retrospective observational study was conducted over a three-month period during the pandemic. Store and forward, video conferencing, and hybrid consultations were included. Two dermatologists of different clinical experience independently assessed the clinical photographs of the patients and gave each photograph an objective score (Physician Quality Rating Scale) and a diagnosis. The diagnostic concordance between the two dermatologists as well as the correlation of this score with the certainty of diagnosis was calculated. Results: A total of 651 patients completed the study. Mean PQRS score of Dermatologist 1 was 6.22 while the mean score of Dermatologist 2 was 6.24. Patients in whom both the dermatologists were absolutely certain about their diagnosis had a higher PQRS score and interestingly had a higher education level than the rest. There was 97.7 percent diagnostic concordance between the two dermatologists. Infections, acne, follicular disorders, pigmentary disorders, tumors, and STDs had the largest proportion of cases wherein both the dermatologists were in total agreement with each other. Conclusion: Teledermatology might be best for the care of patients with characteristic clinical presentation or for follow-up of already diagnosed patients. It can be used in the post-COVID era to triage patients requiring emergency care and reduce patient wait times.
ABSTRACT
Camouflage is defined as a combination of materials, colouration or illumination for concealing something. Skin camouflage therapy is the use of specially formulated products to conceal skin diseases and disfigurements, with the goal of giving a temporarily normal appearance. It gives immediate relief in various dermatological disorders, especially those affecting the visible areas, which are known to be associated with profound psychosocial impact. Despite considerable evidence for its emotional benefits, its utilisation among dermatologists in clinical practice remains low. This article is intended to familiarise dermatologists with the use of skin camouflage therapy including its availability, indications, contraindications, techniques, limitations and future trends.
Subject(s)
Cosmetics , HumansABSTRACT
Platelet rich plasma (PRP) is an upcoming interventional therapy for the treatment of melasma. Its efficacy is due to the multiple growth factors present in it which decrease melanogenesis by various signal transduction pathways. The present study evaluated the efficacy of PRP as a standalone agent in treatment of melasma. This is an open labeled prospective trial. Forty patients were given intralesional PRP at once monthly interval. Three such PRP sessions were carried out and the patients were followed up for 3 months. Assessment was done by calculating the modified melasma area severity index score (mMASI) for each patient. Patients were also asked to self-evaluate their improvement based on a scale. There was an average 54.5% reduction in the mMASI score at the end of the study. There was no relapse in any patient. This reduction was irrespective of the skin type, gender, and type of melasma. Patients self-evaluation showed that more than 90% of the patients were pleased or very pleased with the results. There were no significant side effects. PRP appears to be a potential new therapy with significant efficacy in improving pigmentation of melasma, standalone as monotherapy.
