Use of Teledermatology to Improve Dermatological Access in Rural Areas.

Introduction: Dermatological access in rural regions has been impacted due to an acute, global dermatologist shortage coupled with a striking disparity in dermatologist density between urban and rural areas. As a result, the dermatological arena has been under notable pressure to amplify access. Teledermatology has entailed the use of technology to provide dermatological services to individuals located at a remote distance. The purpose of this literature review was to examine the effect of utilization of teledermatology to determine enhancement of dermatological access to residents of rural areas. Materials and Methods: This review followed a systematic approach and utilized five electronic databases to obtain peer-reviewed journal articles. A PRISMA approach was used and a total of 86 references were employed. Results: Teledermatology programs have been able to complement conventional dermatological care to enhance dermatological access to rural areas that have suffered from a shortage of dermatologists and could aid in supplementing traditional care as well. Within rural settings, the results of three studies in this review indicated the importance of improved quality for diagnostic precision, whereas one study reported that clinical images might not provide sufficient insight to deliver clear-cut diagnoses. In addition, enhancements in diagnostic precision could be obtained by upgrades in phone cameras to capture images. Finally, to most of the existing literature, in using teledermatology, physician satisfaction has been stronger than patient satisfaction. Conclusions: Teledermatology has had a beneficial impact in improving dermatological access to rural areas. The success of this technology is contingent upon the commitment and willingness of the dermatologist in utilizing it.

Brief report: prevalence of attention deficit/hyperactivity disorder among individuals with an autism spectrum disorder.

Currently, both the DSM-IV-TR and ICD-10 preclude the diagnosis of attention deficit/hyperactivity disorder (ADHD) in cases that present with an autism spectrum disorder (ASD). This criterion will be removed in the upcoming DSM-V, but the relationship between ASD and ADHD, and in particular the prevalence of ADHD among the ASD population, remains controversial. Previous studies have reported clinically significant ADHD symptoms in one-third to three-quarters of ASD-affected individuals (probands). In our sample of 1,838 simplex children and adolescents with ASD, we found that less than 16% met clinically significant levels of ADHD symptoms, per parent report. When both parent and teacher reports were considered, the comorbidity rate was even lower, at 2%.