10.5826/dpc.1302a79
text/xml
2160-9381
2631
en
Seçil  Vural
https://creativecommons.org/licenses/by-nc/4.0
Dermatology Practical & Conceptual
corticosteroids
Crusted Scabies of Hands: Constraints of Teledermatology
Text.Serial.Journal
https://dpcj.org/index.php/dpc
Research Letter
2023-04-29
2022-06-02
2023-04-29
2023-06-05
e2023079
Dermatol Pract Concept
Seçil  Vural
2023/04/29
10.5826/dpc.1302a79
e2023079
Department of Dermatology and Venereology, Koç University School of Medicine, İstanbul, Turkey
2160-9381
corticosteroids
en
e2023079
Yeroushalmi S, Millan SH, Nelson K, Sparks A, Friedman AJ. Patient Perceptions and Satisfaction With Teledermatology During the COVID-19 Pandemic: A Survey-Based Study. J Drugs Dermatol. 2021;20(2):178-183. DOI: 10.36849/JDD.5714. PMID: 33538563.
Crusted Scabies of Hands: Constraints of Teledermatology
https://dpcj.org/index.php/dpc/article/download/2631/2066
               Crusted Scabies of Hands: Constraints of
                          Teledermatology
                  Sümeyre Seda Ertekin1, Ayşenur Botsalı2, Senem Danacı3, Seçil Vural1


1 Department of Dermatology and Venereology, Koç University School of Medicine, İstanbul, Turkey
2 University of Health Sciences, Gulhane School of Medicine, Ankara, Turkey
3 Koç University School of Medicine, İstanbul, Turkey



Key words: crusted scabies, teledermatology, contact dermatitis, corticosteroids, COVID19
Citation: Ertekin SS, Botsalı A, Danacı S, Vural S. Crusted Scabies of Hands: Constraints of Teledermatology. Dermatol Pract Concept.
2023;13(2):e2023079. DOI: https://doi.org/10.5826/dpc.1302a79
Accepted: June 20, 2022; Published: April 2023
Copyright: ©2023 Ertekin 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: Secil Vural, MD, Department of Dermatology, Koç University School of Medicine. Telephone: +905054324682
E-mail: sevural@ku.edu.tr




Introduction                                                             presented to our clinic with worsening of pruritus on hands.
                                                                         Face-to-face physical examination revealed hyperkeratotic
During the COVID-19 pandemic, teledermatology has                        and fissured plaques on the dorsum of hands, prominently
emerged as an accurate and cost-effective alternative for                around the proximal phalanges, whereas the palmar sides of
conventional face-to-face dermatological consultations [1].              the hands were relatively spared. Dermoscopic examination
During the pandemic period, we observed 2 cases of crusted               revealed numerous furrows and delta-wing jet signs corre-
scabies induced by prolonged topical potent corticoste-                  sponding to the mites (Figure 1). The patients were diag-
roid use.                                                                nosed with crusted scabies and treated with oral ivermectin
                                                                         and topical 5% sulfur ointment. The consent is taken from

Case Report                                                              each patient to publish their photos and treatment.


Two healthy male (aged 18 and 19 years, respectively) pa-
                                                                         Conclusions
tients were diagnosed with hand irritant contact dermatitis
caused by frequent hand-washing and sanitizer use with                   Physicians and patients report high satisfaction using teleder-
teledermatology. They received topical betamethasone cream               matology, and it has a promising future in daily clinical prac-
treatment initially. The physicians escalated the treatment to           tice [2]. However, there are some concerns regarding the
clobetasol cream occlusion therapy via another telederma-                diagnostic accuracy of teledermatology services. Poor image
tology appointment as the symptoms did not improve.                      quality and the inability of evaluating textural characteris-
    The patients used this therapy continuously without                  tics of lesions may confuse a dermatologist. Here, the lack
any follow-up appointments for one and two months and                    of dermoscopic examination and the inability to perform



Research Letter | Dermatol Pract Concept. 2023;13(2):e2023079                                                                           1
                                  Figure 1. Clinical and dermatoscopic findings. (A-B) Hyperkeratotic
                                  and fissured plaques on the dorsum of the hands in Case 1, with rela-
                                  tively spared palmar side, (C) Thick, hyperkeratotic plaques, erythem-
                                  atous papules on the dorsum of hands of Case 2, (D-E) Numerous
                                  furrows filled with dark-brown triangular structures (delta-wing jet
                                  sign with contrail) corresponding to the mites on the dermatoscopic
                                  examination of Case 1.


a detailed full-body examination may have mislead the cli-              2. Yeroushalmi S, Millan SH, Nelson K, Sparks A, Friedman AJ.
nicians. In teledermatology, if the patient is not improving               Patient Perceptions and Satisfaction With Teledermatology
                                                                           During the COVID-19 Pandemic: A Survey-Based Study. J Drugs
with the prescribed treatment, he/she should be invited for
                                                                           ­Dermatol. 2021;20(2):178-183. DOI: 10.36849/JDD.5714.
the in-person visits to avoid any delay in the diagnosis.
                                                                            PMID: 33538563.


References
 1. Elsner P. Teledermatology in the times of COVID-19 - a system-
    atic review. J Dtsch Dermatol Ges. 2020;18(8):841-845. DOI:
    10.1111/ddg.14180. PMID: 33448667.



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