Dear Editor,
Teledermatology represented a very useful tool during the ongoing pandemic period, leading physicians to guarantee a continuity of care for patients, without exposing both patients and physicians to the risk of COVID‐19 infection. 1 , 2 Although the restart of face‐to‐face visits, teledermatology became part of daily dermatological practice, being particularly useful in cases of chronic skin diseases, requiring long‐term treatments and follow‐up visits. 3 , 4 However, several concerns about the use of teledermatology have been recently raised, regarding privacy problems, and eventual physicians and patients' appreciation of this type of visit.
In this context, we performed a qualitative, questionnaire‐based study, evaluating patients' feelings, appreciations, and concerns about teledermatology visits. Patients suffering from HS and using our teledermatology service were consecutively enrolled in the study. Each enrolled patient was asked to anonymously complete a 6‐item questionnaire evaluating patients' opinions of teledermatology visits. Each patient signed an informed consent before starting the study. A total of 54 patients were consecutively enrolled in the study. However, five patients' questionnaires were excluded due to uncomplete questionnaires received. Hence, a total of 49 questionnaires were considered for the study. (Table 1). Questionnaire answers were resumed in Table 1.
TABLE 1.
Questionnaire used to assess and understand the considerations of patients suffering from hidradenitis suppurativa treated through teledermatology
| Answers (Total: n = 49) | |
|---|---|
| Part A: Demographic and clinical features | |
| 1. Sex | |
| Male | 59.2% (n = 29) |
| Female | 40.8% (n = 20) |
| 2. Age range (years) | |
| 18–34 | 57.1% (n = 28) |
| 35–54 | 30.6% (n = 15) |
| >55 | 12.2% (n = 6) |
| 3. Area involved by hidradenitis suppurativa (choose one or more answers) | |
| Axillary area | 24.4% (n = 12) |
| Pubic area | 30.6% (n = 15) |
| Inguinal area | 16.3% (n = 8) |
| Intermammary area | 20.4% (n = 10) |
| Other | 8.16 (n = 4) |
| Part B: teledermatology | |
| 4. About teledermatology visits | |
| I prefer teledermatology to face to face visits | 28.5% (n = 14) |
| I prefer face to face visits to teledermatology | 22.5%(n = 11) |
| No preferences | 49.0% (n = 24) |
| 5. When using teledermatology service, do You feel safe sharing any required photos or videos? | |
| Yes | 57.1% (n = 28) |
| No | 42,85% (n = 21) |
| 6. If no, why? | |
| I do not feel safe sharing this type of documentation (privacy concerns) | 71,42% (n = 15) |
| I prefer to be visited with a face‐to‐face visit | 14,28% (n = 3) |
| I think it will not be useful | 14,28% (n = 3) |
Interestingly, most of the enrolled patients reported to feel safe using teledermatology service, showing high satisfaction level. However, 22.5% (n = 11) of patients reported to prefer only face to face visits. Interestingly up to 90% of these patients reported HS manifestations at sensitive body areas.
In our opinion, it should be important to improve this service using a widely approved virtual consent form, describing privacy measures applied for patients' data, to increase patient comfort and privacy.
Indeed, in our study, patients referring to prefer face‐to‐face visits than teledermatology services, particularly for those with sensitive areas involved by HS, reported to feel not safe sharing video and/or photo documentation, being aware of eventual unapproved image use, negatively influencing their perception of trust during visits, particularly when sensitive areas were involved.
Hence, we believe that recent improvements and experiences achieved with these services, as well as the diffusion of health technologies, could be the beginning of a larger application of new technologies among both physicians and patients during the pandemic period as well as in normal settings.
Teledermatology surely represented one of the most important visit options during the COVID‐19 era, 1 , 5 , 6 however, we believe that some improvements are still required to reassure both patients, about eventual privacy issues, and physicians, about medical legal responsibility. Hence, more studies and international guidelines are needed to find a standardized online platform, ensuring patients' privacy, as well as widely accepted informed virtual consent for patient.
AUTHOR CONTRIBUTIONS
A.R. and F.M. conceived the idea. A.R., C.M., F.M., G.F., and A.V. designed the study and discussed the ideas. A.R., C.M., F.M., G.F., and A.V wrote the paper. All authors revised and approved the final manuscript.
CONFLICT OF INTEREST
The authors declare that they have no conflicts of interest.
ETHICAL APPROVAL
The authors confirm that the ethical policies of the journal, as noted on the journal’s author guidelines page, have been adhered to. No ethical approval was required as this is a review article with no original research data.
CONSENT
Patients gave their consent for data acquisition and publication.
ACKNOWLEDGMENT
Open Access Funding provided by Universita degli Studi di Napoli Federico II within the CRUI‐CARE Agreement.
[Correction added on 30 November 2022, after first online publication: CRUI‐CARE funding statement has been added.]
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available on request from the corresponding author.
REFERENCES
- 1. Ruggiero A, Megna M, Fabbrocini G, Martora F. Video and telephone teledermatology visits during COVID‐19 in comparison: patients' satisfaction, doubts, and concerns. Clin Exp Dermatol. 2022. doi: 10.1111/ced.15286 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2. Marasca C, Ruggiero A, Napolitano M, Fabbrocini G, Megna M. May COVID‐19 outbreaks lead to a worsening of skin chronic inflammatory conditions? Med Hypotheses. 2020;143:109853. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3. Ruggiero A, Fabbrocini G, Cinelli E, Ocampo Garza SS, Camela E, Megna M. Anti‐interleukin‐23 for psoriasis in elderly patients: guselkumab, risankizumab and tildrakizumab in real‐world practice. Clin Exp Dermatol. 2022;47(3):561‐567. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4. Marasca C, Ruggiero A, Megna M, Annunziata MC, Fabbrocini G. Biologics for patients affected by hidradenitis suppurativa in the COVID‐19 era: data from a referral center of southern Italy. J Dermatolog Treat. 2022;33(1):592. [DOI] [PubMed] [Google Scholar]
- 5. Ibrahim AE, Magdy M, Khalaf EM, Mostafa A, Arafa A. Teledermatology in the time of COVID‐19. Int J Clin Pract. 2021;75(12):e15000. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 6. Martora F, Ruggiero A, Fabbrocini G, Villani A. Patients' satisfaction with remote dermatology consultations during Covid‐19 pandemic. Response to "a qualitative assessment of patient satisfaction with remote dermatology consultations utilised during the UK's first wave of the Covid‐19 pandemic in a single secondary care dermatology department". Clin Exp Dermatol. 2022. doi: 10.1111/ced.15326 [DOI] [PMC free article] [PubMed] [Google Scholar]
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
The data that support the findings of this study are available on request from the corresponding author.