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远程皮肤病学中的银屑病:2016-2020 年圣卡塔琳娜州的分析。

Psoriasis in teledermatology: analysis of the 2016‒2020 period in Santa Catarina.

机构信息

Faculty of Medicine, Universidade do Sul de Santa Catarina, Tubarão, SC, Brazil.

Service of Dermatology, Hospital Universitário Polyodoro Ernani de São Thiago, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil.

出版信息

An Bras Dermatol. 2023 Jan-Feb;98(1):47-58. doi: 10.1016/j.abd.2022.01.010. Epub 2022 Nov 2.

Abstract

BACKGROUND

Psoriasis is a skin disease that affects 1.3% of Brazilians. The use of teledermatology (TD) in the public health sector has democratized access to dermatological care.

OBJECTIVE

To analyze TD exams with suspected and/or diagnosed psoriasis performed between 2016‒2020 in the state of Santa Catarina (SC).

METHODS

Analytical cross-sectional observational study that used secondary data collected from the records of TD exams from the Telemedicine and Telehealth System (TTS) of SC. The associations were evaluated by the chi-square test and Student'st test. The significance level was set at 5% (p < 0.05).

RESULTS

During the period, 6,146 TD exams were related to psoriasis, 58% due to the diagnosis provided by the reporting dermatologist and 42% exclusively due to the suspected disease on the request of the examination. The male sex predominated among the diagnoses of dermatosis (51%; p < 0.001). Regarding risk classification, psoriasis diagnoses were predominantly yellow (58.7%; p < 0.001) or blue (39.7%; p < 0.001) risk, respectively indicating moderate to severe psoriasis (referral to tertiary care) and mild psoriasis (treatment in the primary health care [PHC] level). True positive tests, suspected by PHC and diagnosed with psoriasis through TD, were 34.1% (p < 0.001).

STUDY LIMITATIONS

The TD service is available only for the public health network and analysis for a limited period (five years).

CONCLUSIONS

Psoriasis diagnoses performed by TD, when compared to other dermatoses, tend to receive treatment at the primary (p < 0.001) or tertiary (p < 0.001) health care level, reducing the number of referrals to the secondary care level.

摘要

背景

银屑病是一种影响 1.3%巴西人的皮肤病。远程皮肤病学(TD)在公共卫生部门的使用使皮肤科护理得以普及。

目的

分析 2016 年至 2020 年期间在圣卡塔琳娜州(SC)进行的疑似和/或诊断为银屑病的 TD 检查。

方法

这是一项分析性横断面观察研究,使用了来自 SC 远程医疗和远程保健系统(TTS)的 TD 检查记录中的二级数据。采用卡方检验和学生 t 检验评估关联。显著性水平设置为 5%(p<0.05)。

结果

在此期间,共有 6146 次 TD 检查与银屑病有关,其中 58%是由报告的皮肤科医生提供的诊断,42%仅因检查请求而怀疑患有该病。在皮肤病学诊断中,男性占主导地位(51%;p<0.001)。关于风险分类,银屑病诊断主要为黄色(58.7%;p<0.001)或蓝色(39.7%;p<0.001)风险,分别表示中重度银屑病(转诊至三级保健)和轻度银屑病(在初级保健[PHC]一级治疗)。PHC 疑似并通过 TD 诊断为银屑病的真阳性测试为 34.1%(p<0.001)。

研究局限性

TD 服务仅适用于公共卫生网络,且分析时间有限(五年)。

结论

与其他皮肤病相比,通过 TD 进行的银屑病诊断更倾向于在初级(p<0.001)或三级(p<0.001)保健水平接受治疗,从而减少了向二级保健水平转诊的人数。

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