title: Pediatric teledermatology: observations based on 429 consults.
abstract: BACKGROUND
  Store-and-forward teledermatology is an emerging means of access for patients with skin disease lacking direct access to dermatologists.
  
  
  OBJECTIVE
  We sought to examine the patient demographics, diagnostic concordance, and treatment patterns in teledermatology for patients younger than 13 years.
  
  
  METHODS
  We conducted a descriptive retrospective cohort study involving 429 patients.
  
  
  RESULTS
  Diagnoses were concordant in 48% of cases, partially concordant in 10%, and discordant in 42%. Management recommendations were concordant in 28% of cases, partially concordant in 36%, and discordant in 36%. Primary care providers tended to underuse topical steroids and overuse topical antifungals and systemic antibiotics. Only 1.4% and 6.0% of patients required repeated teledermatology consultation and in-person dermatology consultation, respectively.
  
  
  CONCLUSIONS
  Limitations were the inability to generalize the data from the population studied and the chances of error and bias in teledermatology diagnoses.
  
  
  CONCLUSIONS
  Store-and-forward teledermatology can improve diagnostic and therapeutic care for skin disease in children who lack direct access to dermatologists.
authors.affiliation: Department of Dermatology, University of California, Irvine, California.
authors.forename: Tina S
authors.initials: TS
authors.lastname: Chen
authors.affiliation: Department of Dermatology, University of California, San Francisco, California.
authors.forename: Marc E
authors.initials: ME
authors.lastname: Goldyne
authors.affiliation: Department of Dermatology, University of California, San Francisco, California; Department of Pediatrics, University of California, San Francisco, California.
authors.forename: Erin F D
authors.initials: EFD
authors.lastname: Mathes
authors.affiliation: Department of Dermatology, University of California, San Francisco, California; Department of Pediatrics, University of California, San Francisco, California.
authors.forename: Ilona J
authors.initials: IJ
authors.lastname: Frieden
authors.affiliation: Department of Dermatology, University of California, San Francisco, California; Department of Pediatrics, University of California, San Francisco, California. Electronic address: dr_amy_g@yahoo.com.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Gilliam
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010372:Pediatrics / Q000458:organization & administration; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000458:organization & administration; D019114:Remote Consultation / Q000379:methods; D012189:Retrospective Studies; D012871:Skin Diseases / Q000175:diagnosis* / Q000628:therapy*