Telemedicine and support groups could be used to improve adherence to treatment and health-related quality of life in patients affected by inflammatory skin conditions during the COVID-19 pandemic.

Linked Article: Jakhar, Kaul and Kaur Clin Exp Dermatol 2020; [CED.14227]

We read with great interest the recent article by Jakhar et al. in Clinical and Experimental Dermatology, which reported the measures that could be used during the COVID‐19 pandemic to allow consultations. In particular, they described the growing importance that telemedicine is having during this emergency, focusing on the use of mobile technology (particularly the use of WhatsApp) as a method to communicate via text and voice messages, photos and videos, which is rapidly expanding within the field of telemedicine. We report some of the best strategies and technologies we are using at our outpatient clinic (University of Naples Federico II) during the current pandemic.

Management of both acute and chronic dermatological diseases is always challenging, owing to the variable compliance of patients with the required therapies. Before the current pandemic, we carried out a study among patients with acne, showing the importance of prescribing adequate therapy and of supporting the follow‐up of patients during treatment. In this study, we followed up some patients using text messages (short message service; SMS).

In this study, 160 patients with mild, moderate and severe acne were enrolled and randomly divided into two groups: the SMS group and a control group. All patients in the SMS group received the same text message about their acne medication twice a day for 12 weeks, whereas the control group did not receive any messages. We found that compared with the control group, the SMS group, who received the daily medical support by text, had increased therapeutic adherence with better improvement in all parameters.

The need to support patients and monitor them as closely as possible has become even more important during the current quarantine period, as compliance may be reduced. We are trying to extend this protocol to a larger group of patients, who, owing to the current pandemic, are not able to continue their regular follow‐up visits. By using SMS, patients who need constant support during their treatment period will be able to continue their own therapy, reducing the risk of discontinuation and consequently the risk of the negative clinical impact that could result from nonadherence to treatment.

Although reduction in face‐to‐face consultation is essential reduce the risk of COVID‐19 infection, dermatological services must be continued, and teledermatology may be the solution. The current pandemic is an emerging and rapidly evolving situation, and the use of telemedicine is growing to combat this emergency. Based on our experience, we believe that the use of telemedicine, particularly mobile telemedicine (such as WhatsApp), should be associated with support groups for patients with chronic inflammatory skin diseases, resulting in a more useful strategy to increase adherence to treatment and improve health‐related quality of life, particularly in this unprecedented situation in which face‐to‐face visits are not possible.

However, because guidelines or official recommendations about the use and the efficacy of these new technologies are lacking, different experiences and strategies applied in different hospitals should be shared to identify a common method that works well for both patients and physicians.