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P192 TELEDERMA: telemedicine system for dermatological lesions in patients with inflammatory bowel disease

G. Molina Arriero1, C. Pradera Cibreiro1, C. De las Heras Sotos2, R. Fraga Iriso1, V. Ollero Pena1, M.C. Morete Pérez1, A. Echarri Piudo1

1Complejo Hospitalario Universitario de Ferrol, Gastroenterology, Ferrol, Spain, 2Complejo Hospitalario Universitario de Ferrol, Dermatology, Ferrol, Spain

Background

Dermatological lesions are a common extra-intestinal manifestation (EIM) associated with inflammatory bowel disease (IBD) or its treatment. The severity of the lesions requires a preferential assessment by the dermatologist. The photography allows a telematic evaluation and non-face-to-face analysis. There are no published experiences of telemedicine in patients with IBD and dermatological EIMs. This study aimed to assess the results of a telematic system for the evaluation of dermatological lesions in patients with IBD (TELEDERMA) developed between the Dermatology Department and IBD Unit.

Methods

The retrospective study that evaluates this system from its implementation in June 2014 to December 2017 (3.5 years). TELEDERMA (TD) establishes the issuance of a telematic consultation with images through electronic clinical history. A therapy is advised by a dermatologist either through an electronic prescription or a personal appointment. The study evaluates the average time of the telematic consultation, type of lesion and attitude of patients towards the therapy, type and characteristics of the IBD, treatments applied, other EIMs, smoking and dermatological history. Patients were asked to describe and evaluate their level of satisfaction.

Results

A total number of 47 consultations from 39 patients (70% females) with an average age of 33.2 (8–75) have been made.41 of these consultations were made in patients with Crohn Disease (CD) and 6 in patients with ulcerative colitis (UC). Sixty-seven per cent of the patients with UC had pancolitis. CD Patients had ileal o ileocolonic location (82%) with inflammatory (39%) and stricturing (55%) behaviour. Eighteen per cent of the patients had an active flare-up. 1 out of every four patients had other EIMs. The most frequent reason for teleconsultation was paradoxical psoriasiform lesions (n = 13, 33.3%) of anti-TNF agents (70% of the patients) and suppurative hidradenitis (n = 4, 10.3%). The resolution was achieved in 87%, and only one patient had to interrupt the anti-TNF therapy. The average waiting time was 4.7 days (0–14), compared with the 60 and 28 days of the current waiting list with a routine or preferential request, respectively. All the patients evaluated this system positively, highlighting the advantages of rapidness in both the resolution of the consultations.

Conclusion

TD is a useful tool for the rapid assessment of dermatological lesions associated with IBD. It prevents the patients from going to the emergency department, improves the care quality and the degree of satisfaction of the patients. The most frequent teleconsultations were related to psoriasiform lesions associated with anti-TNF therapy. The interruption of treatment was exceptional.