Patient-Centered Teledermatology: Bridging Pharmacies and Dermatologists

The chronic shortage of dermatologists in France results in average waiting times of 3 months, compromising equitable access to care and early diagnosis of severe conditions such as skin cancers. This pilot project evaluates the feasibility, effectiveness, and acceptability of a tele-expertise platform connecting community pharmacists and dermatologists.

From March 2024 to March 2025, 40 pharmacies (18 urban and 22 rural) submitted 731 dermatological cases via a secure platform, following pharmacist training in clinical photography and best practices. Twelve volunteer dermatologists responded within a target of 24-48 h. Data focused on utilization, response times, pathologies, satisfaction (pharmacist surveys and pharmacist-reported patient feedback), and qualitative feedback from an expert board.

Seven hundred fourteen tele-expertises were completed, with a mean response time of 5.4 days, reflecting early implementation constraints and progressively improving over time (reduced to 1-2 days by study end; 83% < 48 h in February 2025). The main conditions include suspected melanoma (7), carcinomas (27), actinic keratosis, eczema, atopic dermatitis, rosacea, vitiligo, and shingles. Pharmacist satisfaction reached 72% (NPS 24%; 94% recommending a scale-up with adaptations). Pharmacists reported that 88% of patients were satisfied. Limitations comprised the lack of e-prescriptions and the nonintegration of primary care physicians.

This pharmacy-centered model improves rapid access to dermatological expertise, reduces diagnostic delays, and satisfies users, but requires integration into coordinated care pathways (with primary care physicians), pharmacist remuneration, and legal/financial reforms for sustainability. A second pilot is testing these recommendations.