E. Almazan-Delgado , A. Medina-Cobos , M. Cebolla-Verdugo , J. Garzón-Aguilar , C. Llamas-Segura , R. Ruiz-Villaverde
{"title":"利用远程皮肤病学监测的日光光动力疗法治疗肌动性角化病的初级和专科护理的疗效和一致性评估","authors":"E. Almazan-Delgado , A. Medina-Cobos , M. Cebolla-Verdugo , J. Garzón-Aguilar , C. Llamas-Segura , R. Ruiz-Villaverde","doi":"10.1016/j.semerg.2025.102504","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Daylight photodynamic therapy (DL-PDT) is an established option for the treatment of actinic keratoses (AK). In this context, teledermatology has emerged as a promising tool for the follow-up of dermatological patients. This study evaluates the concordance between in-person and teledermatological assessments in the management of AK using DL-PDT.</div></div><div><h3>Material and methods</h3><div>A prospective observational pilot study was conducted on 12 patients treated with DL-PDT. In-person and telematic evaluations were compared regarding the number and severity of lesions, pain, inflammation, efficacy, and cosmetic outcomes. Pearson's correlation coefficients and Cohen's kappa index were used to measure concordance.</div></div><div><h3>Results and discussion</h3><div>The study population consisted predominantly of men (91.7%) with a mean age of 73.9 years. Lesions were located on the scalp (66.7%) and cheeks (33.3%). In-person and teledermatological assessments showed highly similar results for the number of grade I and II lesions (4.4 vs. 4.3 and 1.9 vs. 2.0, respectively). Pain and inflammation, evaluated using the Visual Analog Scale (VAS), were minimal during and after treatment (maximum 1.2<!--> <!-->±<!--> <!-->0.5 points). The cosmetic outcome was excellent, with a mean score of 9.2<!--> <!-->±<!--> <!-->0.9. The concordance between both assessment modalities was perfect (Pearson's correlation coefficient and Cohen's kappa index of 1.000).</div></div><div><h3>Conclusions</h3><div>Teledermatology is a reliable tool for the follow-up of AK treated with DL-PDT, demonstrating results equivalent to in-person evaluation. This supports its implementation in clinical practice, particularly in cases where in-person access is limited.</div></div>","PeriodicalId":53212,"journal":{"name":"Medicina de Familia-SEMERGEN","volume":"51 6","pages":"Article 102504"},"PeriodicalIF":0.9000,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Evaluación de la eficacia y concordancia entre atención primaria y especializada en el tratamiento de queratosis actínicas mediante terapia fotodinámica luz de día monitorizado por teledermatología\",\"authors\":\"E. Almazan-Delgado , A. Medina-Cobos , M. Cebolla-Verdugo , J. Garzón-Aguilar , C. Llamas-Segura , R. Ruiz-Villaverde\",\"doi\":\"10.1016/j.semerg.2025.102504\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><div>Daylight photodynamic therapy (DL-PDT) is an established option for the treatment of actinic keratoses (AK). In this context, teledermatology has emerged as a promising tool for the follow-up of dermatological patients. This study evaluates the concordance between in-person and teledermatological assessments in the management of AK using DL-PDT.</div></div><div><h3>Material and methods</h3><div>A prospective observational pilot study was conducted on 12 patients treated with DL-PDT. In-person and telematic evaluations were compared regarding the number and severity of lesions, pain, inflammation, efficacy, and cosmetic outcomes. Pearson's correlation coefficients and Cohen's kappa index were used to measure concordance.</div></div><div><h3>Results and discussion</h3><div>The study population consisted predominantly of men (91.7%) with a mean age of 73.9 years. Lesions were located on the scalp (66.7%) and cheeks (33.3%). In-person and teledermatological assessments showed highly similar results for the number of grade I and II lesions (4.4 vs. 4.3 and 1.9 vs. 2.0, respectively). Pain and inflammation, evaluated using the Visual Analog Scale (VAS), were minimal during and after treatment (maximum 1.2<!--> <!-->±<!--> <!-->0.5 points). The cosmetic outcome was excellent, with a mean score of 9.2<!--> <!-->±<!--> <!-->0.9. The concordance between both assessment modalities was perfect (Pearson's correlation coefficient and Cohen's kappa index of 1.000).</div></div><div><h3>Conclusions</h3><div>Teledermatology is a reliable tool for the follow-up of AK treated with DL-PDT, demonstrating results equivalent to in-person evaluation. This supports its implementation in clinical practice, particularly in cases where in-person access is limited.</div></div>\",\"PeriodicalId\":53212,\"journal\":{\"name\":\"Medicina de Familia-SEMERGEN\",\"volume\":\"51 6\",\"pages\":\"Article 102504\"},\"PeriodicalIF\":0.9000,\"publicationDate\":\"2025-05-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Medicina de Familia-SEMERGEN\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1138359325000577\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"PRIMARY HEALTH CARE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medicina de Familia-SEMERGEN","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1138359325000577","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PRIMARY HEALTH CARE","Score":null,"Total":0}
引用次数: 0
摘要
日光光动力疗法(DL-PDT)是治疗光化性角化病(AK)的既定选择。在这种情况下,远程皮肤病学已经成为皮肤病患者随访的一个有前途的工具。本研究评估了使用DL-PDT治疗AK的当面和远程皮肤病学评估之间的一致性。材料与方法对12例接受DL-PDT治疗的患者进行前瞻性观察性先导研究。对现场和远程评估进行比较,包括病变的数量和严重程度、疼痛、炎症、疗效和美容结果。采用Pearson相关系数和Cohen kappa指数来衡量一致性。研究人群主要为男性(91.7%),平均年龄73.9岁。病变位于头皮(66.7%)和脸颊(33.3%)。面对面和远程皮肤病学评估显示,I级和II级病变数量的结果非常相似(分别为4.4 vs 4.3和1.9 vs 2.0)。使用视觉模拟评分(VAS)评估疼痛和炎症,治疗期间和治疗后疼痛和炎症最小(最大1.2±0.5分)。美容效果非常好,平均评分为9.2±0.9。两种评估方式的一致性较好(Pearson相关系数和Cohen kappa指数均为1.000)。结论显微皮肤病学是一种可靠的工具,可用于DL-PDT治疗AK的随访,其结果相当于现场评估。这支持其在临床实践中的实施,特别是在亲自访问有限的情况下。
Evaluación de la eficacia y concordancia entre atención primaria y especializada en el tratamiento de queratosis actínicas mediante terapia fotodinámica luz de día monitorizado por teledermatología
Introduction
Daylight photodynamic therapy (DL-PDT) is an established option for the treatment of actinic keratoses (AK). In this context, teledermatology has emerged as a promising tool for the follow-up of dermatological patients. This study evaluates the concordance between in-person and teledermatological assessments in the management of AK using DL-PDT.
Material and methods
A prospective observational pilot study was conducted on 12 patients treated with DL-PDT. In-person and telematic evaluations were compared regarding the number and severity of lesions, pain, inflammation, efficacy, and cosmetic outcomes. Pearson's correlation coefficients and Cohen's kappa index were used to measure concordance.
Results and discussion
The study population consisted predominantly of men (91.7%) with a mean age of 73.9 years. Lesions were located on the scalp (66.7%) and cheeks (33.3%). In-person and teledermatological assessments showed highly similar results for the number of grade I and II lesions (4.4 vs. 4.3 and 1.9 vs. 2.0, respectively). Pain and inflammation, evaluated using the Visual Analog Scale (VAS), were minimal during and after treatment (maximum 1.2 ± 0.5 points). The cosmetic outcome was excellent, with a mean score of 9.2 ± 0.9. The concordance between both assessment modalities was perfect (Pearson's correlation coefficient and Cohen's kappa index of 1.000).
Conclusions
Teledermatology is a reliable tool for the follow-up of AK treated with DL-PDT, demonstrating results equivalent to in-person evaluation. This supports its implementation in clinical practice, particularly in cases where in-person access is limited.