RESUMEN
We compared diagnoses made by a teledermatologist from digital photographs and patient histories sent from general practitioners using a store-and-forward technique and those made by another dermatologist in a face-to-face consultation with the same patients. A total of 117 patients (mean age 47 years) were referred by 18 general practitioners for diagnosis of a skin condition. Between one and seven digital images were transmitted per case. In 31% of the cases, three images were transmitted. There was full concordance between store-and-forward and face-to-face diagnoses in 57 of 106 cases (54%); in 10 cases (9%) there was overlap between the differential diagnoses provided by the teledermatologist and the face-to-face consultant. Diagnostic categories with relatively high concordances were eczema and follicular eruptions. General practitioners need to be trained in the making of digital images and in giving a good patient history.
Asunto(s)
Enfermedades de la Piel/diagnóstico , Telemedicina/métodos , Diagnóstico Diferencial , Eccema/diagnóstico , Medicina Familiar y Comunitaria , Humanos , Persona de Mediana Edad , Consulta Remota/métodos , Reproducibilidad de los ResultadosRESUMEN
OBJECTIVE: Assessment of the efficacy of duplex-guided compression sclerotherapy in patients with varices of the small saphenous vein (SSV). DESIGN: Retrospective. METHOD: Data were collected from 109 patients (14% male and 86% female; average age 51.4 years (SD: 10.6)) with 121 SSV varices which were sclerosed under duplex guidance with polidocanol 3% during the period 1 December 1998-31 May 2001 in the Dermatology department at Maastricht University Hospital, the Netherlands. After-care consisted of a compression bandage for 1 week and a therapeutic elastic stocking for 6 weeks. Check-ups took place after 3-6 months and after 12 months. Sclerosis was repeated if the procedure had failed. Success was defined as occlusion or by the absence of reflux and a reduction in the complaints. RESULTS: After 3-6 months the treatment was successful in 88/113 varices (78%) for which data were available, and after 12 months treatment was successful in 46/57 (81%). CONCLUSION: Sclerosis of the SSV under duplex guidance, with repeat treatment if required, gave favourable results.