Contact Dermatitis. 2021 Apr 9. doi: 10.1111/cod.13856. Online ahead of print.
ABSTRACT
BACKGROUND: Data regarding teledermatology for patch testing are limited.
OBJECTIVES: Compare patch test readings and final interpretation by 2 in-person dermatologists (IPDs) with 8 teledermatologists (TDs).
METHODS: Patch tested patients had photographs taken of 70 screening series allergens at 48-hour (48H) and second (2nd) readings. 8 TDs reviewed photos and graded reactions (negative, irritant, doubtful, +, ++, +++) at 48H and 2nd readings; in addition, they coded a final interpretation (allergic, indeterminant, irritant, negative) for each reaction. TDs rated overall image quality and confidence level for each patient and patch test reaction, respectively. Percentage of TD-IPD agreement based on clinical significance (success, indeterminate, and failure) were calculated. Primary outcome was agreement at 2nd reading.
RESULTS: Data were available for 99, 101, and 66 participants at 48H, 2nd reading, and final interpretation, respectively. Pooled failure (+/++/+++ vs negative) at 2nd reading was 13.6% (range 7.9-20.4%). Pooled failure at 48H and final interpretation was 5.4% (range 2.9-6.8%) and 24.6% (range 10.2-36.8%). Confidence in readings was statistically correlated to quality of images and disagreement.
CONCLUSION: For patch testing, teledermatology has significant limitations including clinically significant pooled failure percentages of 13.6% for 2nd readings and 24.6% for final interpretation. This article is protected by copyright. All rights reserved.
PMID:33837533 | DOI:10.1111/cod.13856
