Psoriasis is a chronic autoimmune condition that causes red, raised, scaly, and often itchy patches on the skin. These symptoms are caused by an overactive immune system, which causes skin cells to grow abnormally quickly.1 The dysfunctional immune response is also responsible for the redness, inflammation, and itchy symptoms associated with psoriasis.
In the United States, many people with chronic skin conditions like psoriasis do not have regular access to dermatologists. This is especially true in rural or other underserved areas or for people with mobility issues.3 In addition, demographic changes are leading to the aging of the American population, while at the same time, fewer dermatologists are entering the profession. This lack of dermatologic care could lead to worse clinical outcomes and reduced quality of life for people with inadequate medical attention.4
Availability of telemedicine
Teledermatology, the practice of consulting with an online dermatologist, continues to expand and provide access to health care professionals for people who need ongoing dermatology care, including those with psoriasis.
There are two main ways people use teledermatology:5
Store-and-forward: This consists of sharing photographs and does not have to happen in real time.
Live interactive: This happens like a real-time appointment over video conference.
These days more services rely on store-and-forward techniques, since the patient and provider do not need to be available at the same time, and the technology is easier and cheaper.6
Teledermatology is Effective for Psoriasis
A new study, conducted by April Armstrong, MD, MPH, of the Keck School of Medicine at the University of Southern California in Los Angeles, shows that teledermatology is as good, and in some cases better, at treating psoriasis than regular in-person appointments with a dermatologist.4 Previous studies have also shown that teledermatology can be used effectively for general dermatology care.7
The psoriasis study was funded by the Patient-Centered Outcomes Research Institute.3 The investigators enrolled 300 patients and randomly assigned them to receive in-person or telemedicine appointments. Online visits involved either the primary care physician or psoriasis patient taking skin photographs. These were then uploaded to a website, where dermatologists could evaluate them and provide recommendations to the patient and the primary care physician at the same time.4
About Psoriasis. National Psoriasis Foundation. Available at https://www.psoriasis.org/about-psoriasis. Accessed March 15, 2018.
Palfreeman AC, McNamee KE, McCann FE (March 2013). New developments in the management of psoriasis and psoriatic arthritis: a focus on apremilast. Drug Des Devel Ther. 7: 201–210. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3615921/. Accessed March 15, 2018.
Improving Specialty-Care Delivery in Chronic Skin Conditions. Patient-Centered Outcomes Research Institute. Available at https://www.pcori.org/research-results/2014/improving-specialty-care-delivery-chronic-skin-diseases. Published March 7, 2018. Accessed March 15, 2018.
Telemedicine OK for Psoriasis Care. MedPage Today. Published by Everyday Health. Available at https://www.medpagetoday.com/meetingcoverage/aad/71260?xid=nl_mpt_DHE_2018-02-21&eun=g1190882d0r&pos=1&utm_source=Sailthru&utm_medium=email&utm_campaign=Daily%20Headlines%202018-02-21&utm_term=Daily%20Headlines%20-%20Active%20User%20-%20180%20days. Published February 2, 2018. Accessed March 15, 2018.
Kara Anderson. How to use teledermatology for psoriasis. National Psoriasis Foundation. Available at https://www.psoriasis.org/advance/how-to-use-teledermatology-for-psoriasis. Published May 6, 2015. Accessed March 15, 2018.
Campagna M, Naka F, Lu J.Teledermatology: An updated overview of clinical applications and reimbursement policies. Int J Womens Dermatol. 2017 May 20;3(3):176-179. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5555283/. Accessed March 15, 2018.
UC Davis dermatologists find telemedicine effective for patient care. UC Davis Health Newsroom. Available at https://www.ucdmc.ucdavis.edu/publish/news/newsroom/6127. Published January 17, 2012. Accessed March 15, 2018.
Comorbidities Associated with Psoriatic Disease. National Psoriasis Foundation. Available at https://www.psoriasis.org/about-psoriasis/related-conditions. Accessed March 15, 2018.