Background:Much interest has been shown in the possibility of using digital images to aid in the more rapid diagnosis of patients with dermatologic disease. A study was undertaken to test the efficacy of the “teleder...Background:Much interest has been shown in the possibility of using digital images to aid in the more rapid diagnosis of patients with dermatologic disease. A study was undertaken to test the efficacy of the “teledermatology”screening of referrals, and thereby to triage the patients to appropriate care. Methods:A retrospective comparison of digital and “face-to-face”diagnoses by two consultant dermatologists was made. Eighty-four images from 75 patients seen in general dermatology clinics were studied. The clinical diagnosis and treatment plan of the patients seen in the clinic by one dermatologist were then compared with those suggested on digital image only, as seen by the other dermatologist. Results:The diagnostic correlation between the two observers was fair, with full agreement in 47 of 84 Gases (56%) and partial agreement in a further 10 (12%). There was no agreement in 14 cases (16.7%); in a further 13 cases, the images and history were not sufficient to allow a diagnosis to be made. The image quality was considered to be poor in 18 cases, but in six of these a diagnosis was still attempted. It was recommended that 66 patients (88%) should be seen in the hospital setting. Thirty patients (40%) received treatment at their visit. Conclusions:Teledermatology is not likely to have a great impact on reducing waiting lists. It is possible that it may help to prioritize referrals from remote areas.展开更多
Anti-tumour necrosis factor-α therapy of Crohn’ s disease (CD) with infliximab has proved a major advance in the treatment of patients with difficult disease. We report our experience of the use of infliximab in a p...Anti-tumour necrosis factor-α therapy of Crohn’ s disease (CD) with infliximab has proved a major advance in the treatment of patients with difficult disease. We report our experience of the use of infliximab in a patient with recalcitrant vulval CD. The introduction of infliximab has improved disease control, although a search for an optimum remittive dosing schedule is ongoing.展开更多
文摘Background:Much interest has been shown in the possibility of using digital images to aid in the more rapid diagnosis of patients with dermatologic disease. A study was undertaken to test the efficacy of the “teledermatology”screening of referrals, and thereby to triage the patients to appropriate care. Methods:A retrospective comparison of digital and “face-to-face”diagnoses by two consultant dermatologists was made. Eighty-four images from 75 patients seen in general dermatology clinics were studied. The clinical diagnosis and treatment plan of the patients seen in the clinic by one dermatologist were then compared with those suggested on digital image only, as seen by the other dermatologist. Results:The diagnostic correlation between the two observers was fair, with full agreement in 47 of 84 Gases (56%) and partial agreement in a further 10 (12%). There was no agreement in 14 cases (16.7%); in a further 13 cases, the images and history were not sufficient to allow a diagnosis to be made. The image quality was considered to be poor in 18 cases, but in six of these a diagnosis was still attempted. It was recommended that 66 patients (88%) should be seen in the hospital setting. Thirty patients (40%) received treatment at their visit. Conclusions:Teledermatology is not likely to have a great impact on reducing waiting lists. It is possible that it may help to prioritize referrals from remote areas.
文摘Anti-tumour necrosis factor-α therapy of Crohn’ s disease (CD) with infliximab has proved a major advance in the treatment of patients with difficult disease. We report our experience of the use of infliximab in a patient with recalcitrant vulval CD. The introduction of infliximab has improved disease control, although a search for an optimum remittive dosing schedule is ongoing.
