Department of Dermatology, Galliera Hospital, Genoa, Italy.
Dermatol Ther. 2020 Jul;33(4):e13495. doi: 10.1111/dth.13695. Epub 2020 Jun 22.
Because of the coronavirus disease 2019 (COVID-19) emergency, on March 9, 2020 Italy went in lock-down imposing the closure of non-urgent outpatient clinics devoted to care of chronic, severe, inflammatory skin diseases that require periodic follow-up. In this emergency situation, due to the lack of a teledermatology platform and in order not to leave our vulnerable high-need patients without proper follow-up, we started a teledermatologic service in smartworking using phone calls and emails. The total number of patients scheduled was 195; in 12 cases, we were not able to talk to the patients. Remote monitoring was performed in 183 patients (126 moderate to severe psoriasis, 10 severe acne, 11 severe atopic dermatitis, 11 hidradenitis suppurativa, 9 blistering autoimmune diseases, and 16 other autoimmune skin diseases). During remote-visits, several interventions were conducted: triage for COVID-19 suspected symptoms, email check of clinical pictures and of laboratory examinations, advices for topical and systemic therapy continuation or discontinuation/switch and reschedule of next appointment. Only five patients required personal office visit (2.7%), reducing consistently the number of face-to face visits. Our real-life experience shows that remote monitoring was effective in preventing unnecessary worsening of severe chronic skin diseases and poor outcomes due to withdrawal of current therapy.
由于 2019 年冠状病毒病（COVID-19）疫情紧急，2020 年 3 月 9 日意大利进入封锁状态，关闭了非紧急的门诊诊所，这些诊所专门治疗需要定期随访的慢性、严重、炎症性皮肤病。在这种紧急情况下，由于缺乏远程皮肤病学平台，为了不让我们脆弱的高需求患者得不到适当的随访，我们开始使用电话和电子邮件在智能办公中开展远程皮肤病学服务。计划预约的患者总数为 195 人；在 12 例情况下，我们无法与患者通话。对 183 名患者进行了远程监测（126 例中重度银屑病、10 例重度痤疮、11 例重度特应性皮炎、11 例化脓性汗腺炎、9 例水疱性自身免疫性疾病和 16 例其他自身免疫性皮肤病）。在远程就诊期间，进行了多项干预：对 COVID-19 疑似症状进行分诊、电子邮件检查临床图片和实验室检查、对局部和全身治疗的继续或停止/换药以及重新安排下次预约的建议。只有 5 名患者需要亲自就诊（2.7%），就诊人数持续减少。我们的实际经验表明，远程监测可有效预防严重慢性皮肤病病情不必要恶化和因停止当前治疗而导致的不良后果。
