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Teledermatologists’ management of emergency skin conditions

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Traditionally, when patients present to emergency departments or rural hospitals with a complex skin condition, the on-call dermatology registrar will be consulted by telephone. More recently, clinicians have begun using store-and-forward technology to send images directly to the specialist, significantly improving their capacity to accurately diagnose and manage patients remotely. Such teledermatology services also provide valuable teaching opportunities for rural doctors and registrars. While there are numerous benefits, including improved timely access to specialist advice for rural patients and clinicians, and reduced unnecessary investigations and outpatient referrals,1 the issues related to patient privacy and confidentiality must be addressed.

Following a successful pilot study in Queensland in 2008–2009,2 the Skin Emergency Telemedicine Service was implemented at the Princess Alexandra Hospital (PAH) in Brisbane. Despite no active promotion of the service, referrals have almost doubled from 167 cases in 20123 to 318 in 2014. The disease spectrum of referred cases in 2014 was similar to 2012, with 30% diagnosed with dermatitis, 21% with infection of the skin and 15% with drug eruption. Referral sites continue to be dispersed across the state, from Brisbane to Innisfail, 1600 km away. After the cessation of outreach services to Qld towns…