Teledermatology During Military Conflicts (Preprint)

BACKGROUND  Telehealth, in particular teledermatology, has become an accepted way to offer necessary consultations and follow-ups, and, most importantly, to triage patients for medical intervention based on urgency. OBJECTIVE  The objective of our study was to assess the success of a teledermatology initiative for the civilian population during a military conflict. METHODS Over 10 months (March 2022 to December 2022), 320 patients were consulted using: (1) store and forward teledermatology, which involves transferring images and clinical information to the dermatologist for review asynchronously; and (2) live interactive teledermatology, usually video conferencing, which allows real-time interaction between the doctor and the patient. The entire project was implemented by dermatologists based in and sponsored by the Euroderm Clinic located in Kiev, Ukraine. RESULTS A total of 320 patients participated. Of the civilian population consulted and managed by dermatologists via the telehealth initiative, the majority of patients (n=208, 65%) were female (mean age 37 years). Males accounted for 35% (n=112) of the sample (mean age 59 years). There were 80 consults involving pediatric patients aged 1 to 16 years, which comprised 25% of all consultations. Preliminary analysis showed that 70% (n=224) of patients experienced an acute exacerbation of chronic skin diseases and skin infections (psoriasis: n=80, 25%; eczema: n=48, 15%; seborrheic dermatitis: n=16, 5%; skin infections: n=32, 10%; skin fungal infections: n=26, 8%; acne: n=22, 7%); 20% (n=64) had skin neoplasms, including benign and malignant ones (melanoma: n=6, 2%; seborrheic keratoma: n=13, 4%; nevus: n=32, 10%; basal cell carcinoma: n=10, 3%; squamous cell carcinoma: n=3, 1%); and 10% (n=32) had skin alterations due to trauma, burns, and postsurgical treatment. CONCLUSIONS Teledermatology aims to provide systematic dermatological services to the most vulnerable people—women, children, and older adults—during military conflicts. According to our study, the majority of diagnoses made using teledermatology were confirmed (n=288, 90%) after an in-person examination. The correct diagnosis was hampered by factors such as poor image quality and periodic lack of internet connection.