Inpatient teledermatology: Current state and practice gaps.

BACKGROUND: Inpatient dermatology care can be challenging for dermatologists. Currently teledermatology is widely used in the outpatient setting but is not common in the inpatient setting, although it has the potential to reduce wait times and improve access to care. OBJECTIVE: To review the available literature on inpatient teledermatology, assess how teledermatology is currently being used in the inpatient setting, and recommend best practice use of inpatient teledermatology. METHODS: A literature review was performed and dermatology attending physicians were surveyed at the Society for Dermatology Hospitalists annual meeting about their current use of inpatient teledermatology. RESULTS: The majority of attending physicians (80.8%, n = 21/26) responded that their institution uses some form of teledermatology. Approximately half of those using teledermatology used it for both inpatient and outpatient consultations (55%, n = 11/20). For institutions with inpatient teledermatology, attending physicians used teledermatology to remotely staff inpatient consultations (81.8%, n = 9/11), triage consultations (63.6%, n = 7/11), and answer curbside questions from primary teams (18.2%, n = 2/11). LIMITATIONS: The limitations of this study include a limited sample size from a single meeting. CONCLUSION: Inpatient teledermatology is currently under-utilized has the potential to increase access to dermatology care and may be best used for triaging and remote staffing. Additionally, standardization of platforms and reimbursement would allow for increased use of inpatient teledermatology.

Assessing factors affecting sunscreen use and barriers to compliance: a cross-sectional survey-based study.

While sunscreen is effective prevention for skin cancer, public sunscreen use and compliance are low. Identifying factors affecting sunscreen use and barriers to compliance are important to understand in order to increase sunscreen use, especially among high-risk individuals. We conducted a single institution survey of 429 dermatology clinic patients to better understand patients' barriers to sunscreen use. Overall several personal barriers to sunscreen use included dislike of feel or appearance of sunscreen (33.7%) and time constraints (15.3%). The cost was a barrier to use in 16.4% of cases underscoring the importance for dermatologists to consider socioeconomic barriers to sunscreen use and provide cost-effective sun protection counseling to patients whenever possible. Dermatologists recommending sunscreen use was associated with a higher rate of use of sunscreen (p < .001) highlighting the important role of sun protective counseling by the dermatologist.

Subepidermal calcified nodule on the periungual finger successfully treated with ablative carbon dioxide laser.

Subepidermal calcified nodules are lesions that primarily affect children and are most commonly located on the head. The current standard of treatment for these is surgical excision. However, surgical excision is not always possible and may not be cosmetically favorable. We describe the use of a CO2 laser as a successful treatment for a subepidermal calcified nodule of the finger.

Patient perceptions of antibiotic use and resistance at a single university dermatology clinic.

Antibiotic resistance is an important problem that requires continued patient education and important prescribing stewardship. Dermatologists prescribe the most antibiotics per provider in comparison to other specialties and have an important role to play in the campaign of mindful prescribing. Data on the dermatology patients' knowledge and perception regarding antibiotic resistance is lacking and could play a role in providers' continuation of medications. We conducted a single institution survey of 512 dermatology clinic patients to understand patient's knowledge and potential gaps. Overall, our results demonstrated an overall higher level of knowledge than expected, there were still several knowledge gaps identified. Ninety-one percent of respondents were aware of the term 'antibiotic resistance'. However, 65% of participants believed that a short course of antibiotics could not cause resistance. While our patients have awareness of antibiotic resistance, it is imperative to continue to assess patients' knowledge about antibiotic resistance and provide education whenever possible in order to continue to practice antibiotic stewardship.