Background

Skin diseases are a common cause of service demand on the primary health care system and the majority of these services are not performed by dermatologists. In general, insufficient undergraduate training is reflected in clinical performance and, consequently, in the referenced services, resulting in increased cost. Teledermatology is the practice of dermatology using information technology and communication systems. It consists of information exchanges between a dermatologist and general practitioners (secondary teledermatology) – either simultaneously or sequentially and in different geographical locations. Secondary Teledermatology promises a more efficient, reasonable and faster treatment in dermatological care, despite insufficient evidence regarding the clinical course of the disease.

Objective

To review the scientific literature which presents evidence of secondary teledermatology in medical practice.

Method

Review of the literature from 1999 to 2014 on clinical trials, observational studies, reviews and systematic reviews identified in PubMed on secondary. teledermatology in medical practice. In addition to these studies, we have included more recent clinical trials in Brazil on the accuracy or agreement of diagnoses made through secondary teledermatology found in the Lilacs bibliographic database, during the same period as well as other relevant studies from other databases regarding medical education and demographics.

Results

The 11 most recent and/or relevant studies in relation to the sample and clinical standard of diagnosis were included. The result of this review was divided into four topics: teledermatology efficiency in primary health care; accuracy, compliance or reliability of the teledermatology diagnosis in primary health care in relation to face-to-face dermatology consultation; patient satisfaction and quality of life; and cost of teledermatology in primary health care. Most of these studies reported good efficiency and diagnostic accuracy with lower costs and better quality of life for patients, in particular for those living in rural areas.

Conclusion

Dermatology is inaccessible without management. We must identify situations in which secondary teledermatology works best, as in remote or underserved areas, allowing patients to have access to dermatologists. The efficiency and accuracy of the diagnoses made through secondary teledermatology is inferior to face-to-face dermatological consultation, but more efficient than the dermatological visits provided by general practitioners.

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