This article was originally published here
Clin Exp Dermatol. 2021 Apr 16. doi: 10.1111/ced.14687. Online ahead of print.
Remote dermatology consultations largely superseded face-to-face (FTF) consultations during the peak of the COVID-19 pandemic in the UK. Remote examination of patients with hidradenitis suppurativa (HS) brings particular challenges, given the propensity of HS to affect intimate body parts. To understand the impact of remote consultations on the care of HS patients, a retrospective analysis was conducted of all consultations from 2 April to 29 October 2020 at the HS clinic at Imperial College Healthcare NHS Trust. 46.3% of HS patients were black, compared to 7% of patients attending general dermatology clinics (p<0.0001). 65.9% of patients had previously received or were currently taking adalimumab. All consultations were performed by telephone, and patients were assessed to have unstable HS (uHS) at 50.7% of consultations. 81.1% of these uHS episodes led to a change in pharmacological therapy. The decision-making process was aided by patient-submitted photographs at only 8.1% of consultations involving uHS, for reasons of patient privacy, comfort, and data security. The data suggest that HS is an inherently unstable disease despite maximal medical therapy, and highlight important reasons for the assessment of HS patients FTF where safely possible.