1 School of Medicine, University of Missouri, Columbia, USA.
2 Department of Dermatology, School of Medicine, University of Missouri, Columbia, USA.
J Telemed Telecare. 2019 Sep;25(8):506-509. doi: 10.1177/1357633X18780562. Epub 2018 Jun 22.
Allergic contact dermatitis (ACD) is a common dermatologic disorder that is estimated to affect 15-20% of the general population. Because of its prevalence, it may be expected that ACD should be easily recognized. However, it can present with many clinical variations that may complicate diagnosis. Although ACD is a treatable condition, patients from rural and underserved areas suffer if timely access to specialty care is limited. Dermatology Extension for Community Healthcare Outcomes (Dermatology ECHO) telemedicine sessions were created to mentor rural primary care providers (PCPs). To illustrate their benefit, we present the case of a 19-year-old female patient who suffered from worsening undiagnosed ACD for over nine months following a laparoscopic appendectomy. During that time, the surgeon and multiple PCPs treated her with antibiotics, antivirals, and Scabicide without improvement in her condition. The de-identified patient case was presented by her PCP during the Dermatology ECHO session. The Dermatology ECHO specialty team mentored and educated the PCP in the diagnosis and treatment of ACD. After making the diagnosis, the patient received new treatment and her condition improved significantly. Dermatology ECHO provides a knowledge-sharing network for participating PCPs that may improve patient outcomes and reduce patient suffering.
变应性接触性皮炎（ACD）是一种常见的皮肤病，估计影响 15-20%的普通人群。由于其普遍性，人们可能期望 ACD 易于识别。然而，它可能表现出许多临床变化，这可能使诊断变得复杂。尽管 ACD 是一种可治疗的疾病，但如果农村和服务不足地区的患者获得专业医疗的机会有限，他们就会受苦。皮肤病延伸社区医疗成果（Dermatology ECHO）远程医疗会议旨在指导农村初级保健提供者（PCP）。为了说明其益处，我们介绍了一位 19 岁女性患者的病例，她在腹腔镜阑尾切除术后 9 个多月来一直患有未经诊断的 ACD，病情不断恶化。在此期间，外科医生和多位 PCP 用抗生素、抗病毒药物和 Scabicide 治疗她，但她的病情没有改善。PCP 在 Dermatology ECHO 会议上介绍了该患者的匿名病例。皮肤病学 ECHO 专业团队指导和教育 PCP 对 ACD 的诊断和治疗。在做出诊断后，患者接受了新的治疗，病情明显改善。Dermatology ECHO 为参与的 PCP 提供了一个知识共享网络，这可能改善患者的预后并减轻患者的痛苦。
