Retrospective study of nail telemedicine visits during the COVID-19 pandemic

Review of Teledermatology: Lessons Learned from the COVID-19 Pandemic

Utilization of telemedicine for dermatology has greatly expanded since the start of the COVID-19 pandemic, with over 500 new teledermatology studies published since 2020. An updated review on teledermatology is necessary to incorporate new findings and perspectives, and educate dermatologists on effective utilization. We discuss teledermatology in terms of diagnostic accuracy and clinical outcomes, patient and physician satisfaction, considerations for special patient populations, published practice guidelines, cost effectiveness and efficiency, as well as administrative regulations and policies. Our findings emphasize the need for dermatologist education, prioritization of reliable reimbursement systems, and technological innovations to support the continued development of teledermatology in the post-pandemic era.

Clinical and dermoscopic findings of benign longitudinal melanonychia due to melanocytic activation differ by skin type and predict likelihood of nail matrix biopsy

BACKGROUND

Longitudinal melanonychia (LM) is a common dermatologic finding in clinical practice with a broad differential diagnosis. Melanocytic activation is the most common LM etiology.

OBJECTIVE

To investigate clinical and dermoscopic differences of benign LM based on Fitzpatrick skin type and in biopsied vs. non-biopsied patients.

METHODS

A 10-year retrospective cohort of 248 benign LM cases at Weill Cornell Dermatology was identified and analyzed.

RESULTS

Darker-skinned vs. lighter-skinned patients had higher band width percentage (p=0.0125), lower band brightness (p<0.001), more band changes (p=0.0071), and received more biopsies (p=0.032). Biopsied (n=47) vs. non-biopsied patients (n=201) had less multidigit band involvement (p=0.0008), higher band width percentage (p=0.0213), lower band brightness (p=0.0003), and more band changes (p<0.0001). Darker skin types more often had brown vs. grey coloration on dermoscopy (p=0.0232). Mean band width percentage for all biopsied patients was 30.81% (range: 5.80%-100%).

LIMITATIONS

Single-center retrospective design. Subungual melanoma and other benign LM etiologies were not analyzed. Only 18.95% of patients received a biopsy.

CONCLUSION

Darker vs. lighter skin types more often present with darker and wider bands, brown vs. grey coloration on dermoscopy, and receive more biopsies. Multi-institutional studies on LM are needed to determine nail matrix biopsy criteria in different skin types.