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  • Ellen Eide Kislal 5:13 pm on April 21, 2011 Permalink | Reply
    Tags: dermatology, , , teledermatology, telemedicine   

    Benefits of an Online Dermatology Consultation 

    There are a number of reasons why one might choose to submit a case to an online dermatologist or nurse practitioner licensed to diagnose, prescribe, and otherwise treat skin conditions in your state.  First, there’s the quick turn-around time.  Tried to get a traditional appointment with a dermatologist lately?  The average wait time nationwide is 38 days, but that nearly doubles to 73 days in Boston. With an online consultation, you can get an answer much faster; generally within 24 hours.

    Modesty is another concern.  Some people would prefer to submit a photo of certain areas rather than to show those areas in person. Not to mention safety. No concerns about acquiring a nasty skin condition while sitting around the dermatologist’s waiting room.

    Cost is certainly another factor.  Online consultations at skinofmine.com vary in price, but are generally in the $30 to $50 range. Roughly the price of a co-pay, but for certain conditions not covered by insurance such as cosmetic issues, this can be a bargain.

    Finally, there’s the convenience and flexibility of having your consultation available 24/7.  No need to take time off from work, pay for gas or parking, or otherwise inconvenience yourself to access the healthcare system.

    What you will get is an entirely new way to interface with the nation’s traditional healthcare system. You can be diagnosed, written a prescription, given OTC recommendations and therapeutic advice, and alerted to helpful reading materials. Will this ever replace in-office visits completely? Of course not. (It’s really hard to do a biopsy remotely…) Handy from time to time? We think so.

    Back to skinofmine.com

    • SWAGATA SAMANTA 10:46 am on May 11, 2011 Permalink | Reply

      I am 38 yrs old lady
      I have melasma in my face
      I want a sunscreen
      I live in Kolkata(India)
      Plz mail me the appropriate sunscreen

      • Ellen Eide Kislal 11:07 am on May 11, 2011 Permalink | Reply

        hi Swagata,
        The American Academy of Dermatology has the following advice on their website aad.org
        “One of the most common treatments for melasma is sun protection. This means wearing sunscreen every day and reapplying the sunscreen every 2 hours. Dermatologists also recommend wearing a wide-brimmed hat when you are outside. Sunscreen alone may not give you the protection you need.”
        For more specific advice tailored to your particular case, please consult with a dermatology professional, either in person or online via skinofmine.com.

    • yummy 2:13 am on November 3, 2011 Permalink | Reply

      I am 30 yrs old. Pls what about melasma from pregnancy how would you advise i cleared that?

      • Ellen Eide Kislal 9:21 am on November 3, 2011 Permalink | Reply

        why don’t you take a photo of your condition and submit it for an online consultation.

      • Dr.Shanmugapriya 12:41 am on August 11, 2012 Permalink | Reply

        Melasma occurring during pregnancy is due to hormonal changes.You can get a dermatologist consultation in person for getting melasma reduced through chemical peels.Do wear a sunscreen with SPF50+ four times a day with adequate physical protection like wearing broadbrimmed hat or using an umbrella.

    • sam 2:53 pm on January 6, 2012 Permalink | Reply

      hello sir..i am male, 19 years old..i just had my wave hair straightened about 6 months ago and suffered hair loss for like 2 months but now it’s almost okay . still a little left but that’ll go away with time i know..i want to know if i could straighten my hair without going through that hair fall or any other problem . for some reason , i just need my hair straightened . any help sir ??

      • Ellen Eide Kislal 3:01 pm on January 6, 2012 Permalink | Reply

        hi Sam, sorry to hear about your troubles. Sorry, I am not an MD and cannot give medical advice.
        Why not take a photo of your scalp and submit for an online consultation at skinofmine.com
        Good luck!

    • Dr. Burns 3:31 pm on March 5, 2013 Permalink | Reply

      I am a dermatologist, however, you suggest that you have shortened the waiting time to see a dermatologist, however, you are not offering dermatologists, instead you are offering mid-level providers, for which there is no waiting time. Yes, it is a low cost alternative, but no, you have not addressed the problem you framed.
      One of the reasons which drives patients to wait for dermatologists is the perceived benefit of accuracy. So, what is the diagnostic accuracy of the providers you offer the public? A study I performed with the Veterans Administration suggests that primary care physicians provide a 30% accuracy in the diagnosis of the skin disease versus 70% by the trained dermatologists, J Am Acad Dermatol. 1999 Nov;41(5 Pt 1):693-702.
      What I am suggesting is that the cost effectiveness of this online program would appear to be lower than you state by providing a low value product. As you are not an MD, perhaps you should not be supervising an online medical advice system.

      • Ellen Eide Kislal 3:41 pm on March 5, 2013 Permalink | Reply

        Dr. Burns:
        Thank you for sharing your opinion. To clarify, we in fact do offer dermatologists as well as other options such as NPs and PAs. In the case of the NPs and PAs, we do require that they have experience in dermatology specifically. The question is, in our opinion, not so much specialist vs. generalist. Rather it is in-person vs. tele, where I believe the literature shows similar accuracy between the two. Further, cost is only one advantage; others include convenience and privacy.
        Ellen Eide Kislal, PhD

  • Ellen Eide Kislal 4:55 pm on November 9, 2010 Permalink | Reply
    Tags: area, dermatology, measuring, monitoring, quantifying, , tracking, VASI, VIDA, vitiligo   

    Quantifying and Tracking Vitiligo 

    “When determining the effectiveness of a specific treatment for a specific disease, it is important to have a reproducible, validated, pragmatic, and sensitive scoring system .” [1] Traditionally, the job of scoring has fallen to the dermatologist, who has two fairly widely accepted scoring systems available to help monitor vitiligo:  the vitiligo area severity index (VASI) [2] and the vitiligo disease activity score (VIDA) [3].

    VASI involves breaking the body into “hand units,” each of which is approximately 1% of the total surface area of the body. Within each hand unit, the degree of depigmentation is estimated and quantized into one of 6 levels. The total VASI is then the sum of the quantized depigmentation levels, where the sum runs over all hand units.

    The VIDA is a six-point scale for assessing vitiligo activity based on the individual’s own opinion of the present disease activity over time.

    Both VASI and VIDA are convenient approximations in the absence of tools. But why not use tools! Why break the body into “hand units” when you can precisely measure the total surface area affected? Why use a subjective method of tracking changes, when you can do a mathematical alignment of two images?

    Once tools are introduced, patients should have access to them, in order to be able to monitor their conditions themselves.

    Skinofmine.com has developed a simple system for precisely determining the extent of vitiligo and its progression, based on standard measures and machine learning techniques.  We measure the extent of vitiligo in square millimeters, and use clustering techniques to precisely locate depigmented areas. We take scaling, rotation, and translation into account while determining the best alignment of two images for the purpose of visualizing changes over time.

    We do hope these quantification tools will prove useful in the monitoring of vitiligo by patients and doctors alike.

    Back to skinofmine.com

    [1] James Ferguson, MD, FRCP. Published in Journal Watch Dermatology July 28, 2004, covering Arch Dermatol 2004 Jun; 140:677-83

    [2] Hamzavi I, Jain H, McLean D, Shapiro J, Zeng H, Lui H. Parametric modeling of narrowband UV-B phototherapy for vitiligo using a novel quantitative tool: The Vitiligo Area Scoring Index. Arch Dermatol 2004;140:677-83.

    [3] Njoo MD, Das PK, Bos JD, Westerhof W. Association of the Koebner phenomenon with disease activity and therapeutic responsiveness in Vitiligo Vulgaris. Arch Dermatol 1999;135:407-13.

  • Ellen Eide Kislal 3:21 pm on October 27, 2010 Permalink | Reply
    Tags: , analyze, , dermatology, , , , , ,   

    Quantifying Acne 

    We used the Skin Of Mine Acne module at skinofmine.com to quantify acne of six individuals, where the severity of the acne of the individuals ranged from none to severe.  In each case, the computer mouse was used to manually highlight the areas of concern for each individual.  Results are shown below. The lower row of images shows the highlighted regions in green.


    Quantification results coincide well with visual assessments. Note that for individual 3 (Acne Index of 56) the index would likely be higher if the entire face were exposed.

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