Teledermatology management of difficult-to-treat dermatoses in the Faroe Islands.

Teledermatology is a useful tool for underserved areas. However, because it is not without costs, knowledge of the burdens incurred by teledermatology treatment would be valuable for future types of management.
All specialist dermatology services in the Faroe Islands have been provided by our department through a mix of standard and teledermatology consultations. We performed a retrospective review of the teledermatology database from its inauguration in 2003 to November 2018. The ratio of consultations per patient (CPP) was calculated as a way to investigate any disproportionate teledermatology burden per patient with a specific disease.
The most common diagnoses were psoriasis, dermatitis, atopic dermatitis, and acne. Among the most frequent CPP diagnoses were bullous pemphigoid, hidradenitis suppurativa, lichen sclerosus, and granuloma annulare.
Dermatological conditions that require paraclinical assistance for diagnosis, hands-on examination, or treatment with either biologics or surgery will all result in high CPP. However, teledermatology still has a place in the treatment of high-CPP dermatoses in rural areas because there is no other alternative. For non-rural areas, CPP can be used as a way to identify those dermatoses that are not advantageous to treat using telemedicine, but instead best benefit from standard face-to-face consultation.