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Online vs In-Person Care for Atopic Dermatitis: A Randomized Clinical Trial.

April W Armstrong1,2, Alyssa M Roberts1,3, Gina Kostandy2

  • 1Division of Dermatology, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles.

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|June 24, 2026
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Summary
This summary is machine-generated.

An online, team-based connected health model demonstrated equivalent improvements in atopic dermatitis (AD) severity compared to traditional in-person care. This telehealth approach offers a scalable solution for managing AD effectively.

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Area of Science:

  • Dermatology
  • Connected Health
  • Clinical Trials

Background:

  • Accessible and effective management of atopic dermatitis (AD) is crucial, yet scalable, collaborative care models integrating patients, primary care, and specialists are lacking.
  • Geographic barriers often limit access to specialized dermatological care for AD patients.

Purpose of the Study:

  • To evaluate the equivalence of an online, team-based connected health (TCH) model in improving AD severity compared to conventional in-person care.
  • To determine if telehealth can provide comparable outcomes to in-person visits for managing atopic dermatitis.

Main Methods:

  • A pragmatic, randomized clinical equivalence trial enrolled 300 patients with AD from 8 dermatology clinics.
  • Participants were randomized 1:1 to either an online TCH model with asynchronous dermatologist review of photos or conventional in-person care.
  • The primary outcome was the 12-month change in the Eczema Area and Severity Index (EASI), with secondary outcomes including POEM and vIGA.

Main Results:

  • The TCH model showed a mean EASI change difference of -0.01 (95% CI, -0.22 to 0.20) between groups, falling within equivalence margins.
  • Secondary outcomes, POEM (0.38 difference) and vIGA (0.06 difference), also demonstrated equivalence between the online and in-person care groups.
  • All primary and secondary outcome differences were within the prespecified equivalence margins, indicating comparable efficacy.

Conclusions:

  • The online TCH model achieved equivalent improvements in AD signs and symptoms compared to in-person care.
  • Telehealth models, such as the TCH approach, show promise as effective tools for managing chronic dermatological conditions like AD.
  • This study supports the integration of connected health strategies to improve access and management of atopic dermatitis.