E Caumes1, V Le Bris, C Couzigou, A Menard, M Janier, A Flahault. 1. Department of Infectious Diseases, Service des Maladies Infectieuses et Tropicales, Hôpital de la Pitié-Salpétrière, 47-83 Boulevard de l'Hôpital, 75013 Paris, France. eric.caumes@psl.ap-hop-paris.fr
Abstract
BACKGROUND: The pattern of dermatoses occurring in travellers to tropical areas is poorly documented. OBJECTIVES: To diagnose skin diseases in travellers to Burkina Faso by means of teledermatology; to assess the educational value of teledermatology for the local general practitioner (GP). METHODS: Patients (Westerners and Burkinabese nationals) were included in the study if they presented with a cutaneous disease to the GP based in Ouagadougou, Burkina Faso. Images of the skin lesions were acquired with a point-and-shoot digital camera and sent via the Internet, together with the clinical history. Diagnostic concordance between dermatologists in France and the GP in Ouagadougou was analysed as a simple proportion of agreement and 95% confidence interval. RESULTS: One hundred and twenty-four patients (M/F ratio 1.17; 80.6% Westerners) were included in the study. One hundred and thirty dermatoses were identified: 73 (56%) were of infectious origin, and 19 (15%) were related to eczematous dermatitis. The skin infections were mainly due to bacteria (18%), fungi (14%) or arthropods (13%). Parasitic dermatoses were observed only in Burkinabese nationals. Among Westerners, fungal dermatoses were observed only in long-term residents. The diagnostic agreement between the local GP and the remote dermatologists was 49% overall (95% confidence interval 41-58). Agreement between the GP and the dermatologists on the dermatological category improved significantly over time (P<0.05). CONCLUSIONS: Telemedecine can improve the management of cutaneous diseases among Western travellers. Most dermatoses observed in Western travellers to Burkina Faso are of infectious origin. Teledermatology has educational value for local GPs.
BACKGROUND: The pattern of dermatoses occurring in travellers to tropical areas is poorly documented. OBJECTIVES: To diagnose skin diseases in travellers to Burkina Faso by means of teledermatology; to assess the educational value of teledermatology for the local general practitioner (GP). METHODS:Patients (Westerners and Burkinabese nationals) were included in the study if they presented with a cutaneous disease to the GP based in Ouagadougou, Burkina Faso. Images of the skin lesions were acquired with a point-and-shoot digital camera and sent via the Internet, together with the clinical history. Diagnostic concordance between dermatologists in France and the GP in Ouagadougou was analysed as a simple proportion of agreement and 95% confidence interval. RESULTS: One hundred and twenty-four patients (M/F ratio 1.17; 80.6% Westerners) were included in the study. One hundred and thirty dermatoses were identified: 73 (56%) were of infectious origin, and 19 (15%) were related to eczematous dermatitis. The skin infections were mainly due to bacteria (18%), fungi (14%) or arthropods (13%). Parasitic dermatoses were observed only in Burkinabese nationals. Among Westerners, fungal dermatoses were observed only in long-term residents. The diagnostic agreement between the local GP and the remote dermatologists was 49% overall (95% confidence interval 41-58). Agreement between the GP and the dermatologists on the dermatological category improved significantly over time (P<0.05). CONCLUSIONS: Telemedecine can improve the management of cutaneous diseases among Western travellers. Most dermatoses observed in Western travellers to Burkina Faso are of infectious origin. Teledermatology has educational value for local GPs.