Psoriasis is a chronic autoimmune disease characterized by the rapid buildup of skin cells, leading to thick, scaly, and often itchy patches. This condition requires ongoing care and monitoring to manage symptoms and prevent complications. Telehealth, the remote delivery of healthcare services using technology, has emerged as a practical way to manage this long-term condition. The suitability of using virtual visits for this visually-assessed skin disease depends on the specific needs of the patient and the phase of their treatment.
How Telehealth Facilitates Psoriasis Monitoring and Management
Remote assessment of psoriasis is achieved through a combination of asynchronous and synchronous communication methods. Asynchronous communication involves the patient sending high-resolution photographs or videos of the affected areas to the dermatologist before the consultation. These images allow the clinician to examine the texture, redness, and scaling of the plaques in detail, often more clearly than through a live video feed alone.
The live, synchronous video conference allows for a real-time discussion about symptoms, side effects, and the overall patient experience. During this call, the dermatologist can guide the patient to position the camera to show different angles or hard-to-reach areas, such as the scalp or back. Patients are often trained to track their symptoms and estimate the affected body surface area (BSA). This estimation helps the clinician quantify disease severity and determine if the current treatment plan is effective.
Advantages of Virtual Care for Chronic Psoriasis Patients
Using virtual care for chronic psoriasis management offers significant benefits, particularly concerning continuity of care and patient convenience. Telehealth eliminates the need for travel, saving patients time and money on transportation and potential time off work. This is particularly helpful for individuals in rural areas or those with limited mobility due to severe plaques or associated psoriatic arthritis.
The convenience of virtual appointments makes it easier to schedule the frequent follow-up visits necessary for chronic conditions like psoriasis. Regular check-ins are important for monitoring medication effectiveness, making timely adjustments to treatment regimens, and promoting adherence. Studies have shown that tele-dermatology can be as effective as in-person care for improving disease severity and quality of life outcomes. Furthermore, a virtual setting provides a more comfortable and private environment for patients to discuss sensitive concerns or show lesions on private areas of the body.
When In-Person Visits Remain Essential
While telehealth is highly effective for routine monitoring and follow-up care, certain situations still require an in-person examination or procedure. Initial diagnosis of a new, complex skin condition requires a hands-on assessment to rule out other diseases, and diagnostic procedures like a skin biopsy cannot be performed virtually. In-person visits are also necessary when initiating certain treatments, such as the first session of phototherapy or training on self-administering injectable biologic medications.
Physical presence is necessary for assessing acute, severe complications, such as a suspected skin infection presenting with pus, heat, or ulceration. For patients with psoriatic arthritis, a full physical assessment of the joints is required to accurately determine disease activity and progression, which is difficult to do adequately through a screen. If a clinician cannot adequately assess subtle skin changes, such as induration (thickness) or deep lesions, due to poor image quality, an in-person visit is the necessary alternative.
Preparing for a Successful Psoriasis Telehealth Appointment
Maximizing the effectiveness of a virtual visit requires proactive preparation from the patient. You should ensure you are in a quiet, private, and well-lit space, as natural light is generally the best for accurately assessing skin tone and redness. Before the appointment begins, take high-quality, focused photos of all affected areas, including both close-ups and wider shots for context, and upload them to the secure patient portal if requested.
It is helpful to have a comprehensive list of all current medications, including any over-the-counter creams, supplements, or new treatments you have tried since your last visit. You should also prepare a list of specific questions regarding any symptoms, recent flares, or side effects you may be experiencing. Being organized and ready to discuss your symptoms in detail helps the dermatologist make informed decisions about your ongoing care plan.