Store-and-forward teledermatology versus in-person visits: a comparison in pediatric teledermatology clinic.
BACKGROUND
The role of teledermatology in the diagnosis of pediatric skin conditions has not been studied exclusively.


OBJECTIVE
To determine the ability of a pediatric dermatologist to correctly diagnose rashes by history and digital images.


METHODS
Consecutive, new referrals to the pediatric dermatology clinic with a rash were enrolled in the study. A history, demographic data, and digital photographs were obtained from each patient. The data were reviewed by a pediatric dermatologist who made a preliminary diagnosis. The child was then seen in person and a final diagnosis was made. Concordance and kappa values were calculated. Cases of diagnostic disagreement were analyzed for their effect on management.


RESULTS
One hundred thirty-five patients were enrolled. Diagnostic concordance was 82% (95% confidence interval [CI], 73%-88%), and the kappa value was 0.80. Clinically relevant disagreement occurred in 12% of cases.


CONCLUSIONS
The study was performed at a single site, theoretically limiting generalizability.


CONCLUSIONS
Teledermatology appears to have a useful role in the care of children with rashes.
Department of Pediatrics, Section of Emergency Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA. vheffner@mcw.edu
Viday A
VA
Heffner
Valerie B
VB
Lyon
David C
DC
Brousseau
Kristin E
KE
Holland
Kenneth
K
Yen
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003201:Computers; D005076:Exanthema / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D015588:Observer Variation; D017216:Telemedicine / Q000379:methods*