title: A prospective study on the use of teledermatology in psychiatric patients with chronic skin diseases.
abstract: BACKGROUND
  To compare the use of live interactive teledermatology versus conventional face-to-face consultation in long-term, institutionalised psychiatric patients with chronic skin diseases.
  
  
  METHODS
  All institutionalised psychiatric patients at the Institute of Mental Health with follow-up appointments at the National Skin Centre were assessed for eligibility and invited to participate. Recruited patients were first seen by a dermatologist via videoconferencing, and then by another dermatologist in person, within 1 week. Clinical outcome measures were then assessed by a third independent dermatologist. The following outcome measures were assessed for each paired patient visit: inter-physician clinical assessment, diagnosis, management plan, adverse events and total patient turnaround time (PTAT) for each consultation.
  
  
  RESULTS
  There were a total of 13 patients (mean age, 64.6 years; range 44-80) with 27 patient visits. All were male patients with chronic schizophrenia. The predominant skin condition was chronic eczema and its variants (62%), followed by cutaneous amyloidosis (23%) and psoriasis (15%). The level of complete and partial agreement between the teledermatology and face-to-face consultation was 100% for history-taking and physical examination and 96% for the investigations, diagnosis, management plan and the treatment prescribed. The PTAT for teledermatology was 23 min, compared to 240 min for face-to-face consultations. No adverse events were reported.
  
  
  CONCLUSIONS
  Teledermatology was as effective as face-to-face consultation and reduced the PTAT by 90%, resulting in increased patient convenience, operational efficiency and reduced manpower need. Our study supports the safe and cost-effective use of teledermatology for the follow-up of chronic skin conditions in psychiatric patients.
authors.affiliation: National Skin Centre, Singapore.
authors.forename: Amelie C
authors.initials: AC
authors.lastname: Seghers
authors.affiliation: Institute of Mental Health, Singapore.
authors.forename: Kok Han
authors.initials: KH
authors.lastname: Seng
authors.affiliation: National Skin Centre, Singapore.
authors.forename: Martin T W
authors.initials: MT
authors.lastname: Chio
authors.affiliation: Institute of Mental Health, Singapore.
authors.forename: Emileen
authors.initials: E
authors.lastname: Chia
authors.affiliation: National Skin Centre, Singapore.
authors.forename: See Ket
authors.initials: SK
authors.lastname: Ng
authors.affiliation: National Skin Centre, Singapore.
authors.forename: Mark B Y
authors.initials: MB
authors.lastname: Tang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003880:Dermatology / Q000379:methods*; D006801:Humans; D007326:Institutionalization; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012559:Schizophrenia / Q000150:complications*; D012871:Skin Diseases / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D017216:Telemedicine; D013997:Time Factors; D049269:Videoconferencing
keywords: teledermatology