Assessing Acne Severity: Teledermatology Versus Face to Face Consultations During the COVID-19 Pandemic

Acne vulgaris is a common skin disorder in pilosebaceous units that is self-limited, especially in adolescents. This disease not only causes permanent physical complications but also psychosocial effects that harm the quality of life. Telemedicine has grown its popularity in recent years, especially during the COVID-19 pandemic. Store and Forward (SAF) teledermatology using digital cameras has also increased patient service satisfaction, promising diagnostic reliability, and clinical outcomes similar to face-to-face visits.

We sought to compare the severity of acne vulgaris by teledermatology with face-to-face consultations. We also observe the capability of teledermatology in establishing the severity of acne vulgaris.

This study is an observational analytic study with a cross-sectional design involving 105 patients with a diagnosis of acne vulgaris based on inclusion and exclusion criteria. The characteristics of age and sex were recorded. The severity of acne vulgaris was established directly by the resident and teledermatologically by the dermatologist consultant. Teledermatology was carried out based on photo documentation of five facial lesion areas; namely forehead, chin, right cheek, left cheek, and the entire face, along with photos from the history submitted by the resident. An assessment for acne vulgaris severity was carried out based on the classification from the International Consensus Conference on Acne Classification System. This classification divided acne vulgaris as mild, moderate, and severe with an ordinal measuring scale. A compatibility test was also performed to determine the comparison between teledermatology and face-to-face consultations in establishing the severity of acne vulgaris. Comparison of the severity of acne vulgaris was assessed by the kappa value.

Acne vulgaris was found more common in women (n=71, 67.6%) and those aged 18 to 22 years (n=55, 52.4%). Most of the subjects have moderate severity based on face-to-face consultations and teledermatology examination (n=52 (49.5%) and n=50 (47.6%), respectively). The value of the capability test between teledermatology and face-to-face consultations in comparing the severity of acne vulgaris is 0.611, which means the capability is considered good.

In this study, the teledermatology examination shows good conformity when compared with face-to-face consultations in assessing severity of acne vulgaris.