10.5826/dpc.1304a238
text/xml
2160-9381
3368
en
Kazuhiko Kotani
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
Step for the Further Introduction of Teledermatology to Daily Practice in Rural and Underserved Areas
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Letter to the Editor
2023-10-31
2023-03-24
2023-10-31
2024-01-15
e2023238
Dermatol Pract Concept
Kazuhiko Kotani
2023/10/31
10.5826/dpc.1304a238
e2023238
Division of Community and Family Medicine, Jichi Medical University, Shimotsuke-City, Japan
2160-9381
en
e2023238
Ahuja S, Briggs SM, Collier SM. Teledermatology in rural, underserved, and isolated environments: A review. Curr Dermatol Rep. 2022; 11:328-335.
Step for the Further Introduction of Teledermatology to Daily Practice in Rural and Underserved Areas
https://dpcj.org/index.php/dpc/article/download/3368/2258
               Step for the Further Introduction
         of Teledermatology to Daily Practice in Rural
                    and Underserved Areas
                                                         Kazuhiko Kotani1


1 Division of Community and Family Medicine, Jichi Medical University, Shimotsuke-City, Japan



Citation: Kotani K. Step for the Further Introduction of Teledermatology to Daily Practice in Rural and Underserved Areas.
Dermatol Pract Concept. 2023;13(4):e2023238. DOI: https://doi.org/10.5826/dpc.1304a238
Accepted: April 10, 2023; Published: July 2023
Copyright: ©2023 Kotani et al. This is an open-access article distributed under the terms of the Creative Commons
Attribution-NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted
noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited.
Funding: None.
Competing Interests: None.
Authorship: All authors have contributed significantly to this publication.
Corresponding Author: Kazuhiko Kotani, MD, PhD, Division of Community and Family Medicine, Jichi Medical University, 3311-1
Yakushiji, Shimotsuke-City, Tochigi 329-0498, Japan. Tel: +81-285-58-7394, fax: +81-285-44-0628 E-mail: kazukotani@jichi.ac.jp




Dear Editor,                                                             the diagnosis and treatment of skin diseases between der-
                                                                         matologists and primary care providers working in rural
    We read with great interest the Duniphin study showing               and underserved areas is reported to be relatively low [4].
that the insurance and income level, as well as rural residence,         Accordingly, these regularly require timely access to and
are related to barriers to the introduction of teledermatol-             quality care by dermatologists.
ogy into the underserved populations [1]. As barrier-focused                  In the time of COVID-19 pandemic, telemedicine has
surveys on teledermatology specifically for rural and under-             developed to bridge the healthcare disparity over distances,
served areas have rarely been conducted, the study is valu-              and it is now accepted in rural and underserved areas [5].
able for forming a public strategy [1]. As a rural researcher,           Teledermatology is being increasingly used in clinical set-
I would like to add some comments while considering the                  tings with real-time and high-quality views [5]. Advances
recent situation of rural and underserved healthcare.                    would allow dermatologists (even those working in urban
    Skin problems are one of the most common diseases en-                areas) more chances to practice in rural and underserved
countered in daily practice in rural and underserved areas [2].          areas. The educational effect of teledermatology is also im-
The numbers of dermatologists who willingly conduct ru-                  plied for primary care providers [4]. Thus, teledermatology
ral practice are unlikely to increase although programs have             not only benefits patients in practice but also offers learning
been attempting to rectify the geological maldistribution of             opportunities to primary care providers.
dermatologists (ie, shortage of dermatologists in rural and                   There are currently sub-specialized dermatologists and
underserved areas in comparison to urban areas) [3]. The                 medical staff in the dermatological field, such as pediatric der-
provision of dermatology training to primary care pro-                   matologists, dermatopathologists and skin psychologists [2].
viders also remains insufficient [2], and the consistency of             Although it is difficult to meet sub-specialized experts in a




Letter to Editor | Dermatol Pract Concept. 2023;13(4):e2023238                                                                          1
single practice in rural and underserved areas, teledermatol-    2. Lewis H, Becevic M, Myers D, et al. Dermatology ECHO - an
ogy may make such team-based approaches possible.                   innovative solution to address limited access to dermatology ex-
                                                                    pertise. Rural Remote Health. 2018;18(1):4415. DOI: 10.22605
    Even though teledermatology does not solve all clinical
                                                                    /RRH4415. PMID: 29409325.
problems, public policy with financial support may be needed
                                                                 3. Li A, Toy J, Purdy K, Kirshen C, Liu C. Rural educational op-
as the next step as suggested by the Duniphin study [1].            portunities in dermatology residency programs: The solution to
More recently, the use of telemedicine has been positioned          geographic maldistribution and shortage of dermatologists in
in government medical plans for rural healthcare in Japan,          Canada? J Cutan Med Surg. 2023;27(2):174-175. DOI: 10.1177
which are accompanied by financial support. Various public          /12034754221149653. PMID: 36653960.
                                                                 4. Becevic M, Ge B, Braudis K, et al. Diagnostic and treatment
actions are called for the further introduction of telederma-
                                                                    concordance in primary care participants and dermatologists
tology into daily practice in rural and underserved areas.
                                                                    utilizing Extension for Community Health Outcomes (ECHO).
                                                                    J Telemed Telecare. 2023;:1357633X221147074. DOI: 10.1177

References                                                          /1357633X221147074. PMID: 36654477.
                                                                 5. Ahuja S, Briggs SM, Collier SM. Teledermatology in rural,
1. Duniphin DD. Limited access to dermatology specialty care:       underserved, and isolated environments: A review. Curr Der-
   Barriers and teledermatology. Dermatol Pract Concept. 2023;      matol Rep. 2022;11(4):328-335. DOI: 10.1007/s13671-022-
   13(1):e2023031. DOI: 10.5826/dpc.1301a31. PMID: 36892370.        00377-2. PMID: 36310767. PMCID: PMC9589860.
   PMCID: PMC9946088.




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