[Teleconsultation in dermatology: lessons from 13 cases].

Modern communications technologies have facilitated access to information and development of databases. Teleconsultation especially over the internet is a promising technique that allows transfer of clinical, laboratory and radiological files to outside specialists. The purpose of this report is to describe the value and limitations of teleconsultation in dermatalogy based on a selection of internet messages sent to the military hospital in Marseille, France by physicians carrying out overseas missions or assigned to remote locations. The quality of the message including proper description of symptoms, thorough history-taking, and definition of attached images as well as the field experience of the specialists receiving the message were determinant factors for the effectiveness of the response. Feedback is also of fundamental importance in improving expertise. The main problem is that conclusive diagnosis is often prevented by inadequacies in the field, i.e., inability to perform confirmation testing, lack of therapeutic capability, and inability to obtain sufficient follow-up information to evaluate the outcome of presumptive treatment. Work is currently underway to standardize messaging techniques based on pre-establish decision-tree algorithms.