Principal Findings
anxiety, psoriasis, pain, depressive, hand and foot eczema, eczema
DISEASE, PSORIASIS, DERMATOLOGICAL DISEASES, SKIN CONDITION, ECZEMA
In our intervention study, we showed that the use of our monitoring app in combination with a patient education session has a significant effect on quality of life, pain, activity, and clinical outcome if the app is not used more than once every 5 weeks. In addition, men seem to profit more from app use frequency than women regarding the clinical outcome.We first analyzed differences between the intervention and control groups in regard to amelioration of quality of life, pain, activity, and eczema. All our study patients, independent of group membership, had less pain, showed an enhanced quality of life, and participated more actively in life; in addition, their skin condition improved over time. Although the intervention group showed a stronger improvement at all times, the difference between the 2 groups never reached significance. As our patients received a physician’s appointment every 3 months regardless of their skin condition, we conclude that the regular physician-patient contact was crucial for the amelioration of the disease in both groups. This aligns with the observations of Riedl et al [In our previous intervention study involving a 60-week monitoring app for patients with psoriasis, we were able to show that patient education in combination with a monitoring app resulted in a significant amelioration of depressive and anxiety symptoms in patients who used the app fewer than once a month [We additionally assessed whether patients reduce the app use frequency as their outcomes improve, but the subgroup with <20% app use frequency showed lower app use frequency from the start, with no decrease in the use in the course of time.By contrast, the app provided in the study allowed direct contact between patients and their treating physicians, which probably reassured patients and improved quality of life in the intervention group when using the app fewer than once a week. We believe that the mere possibility of being able to contact the supervising physician if needed rather than the frequency of physician-patient contact is decisive to improved quality of life. In our clinical perception, frequent physician’s appointments to obtain a follow-up prescription may become a burden, in particular for younger patients who have less time because of their jobs. Such patients might benefit significantly from additional teledermatological care.Another finding of our study was that the HECSI of male participants decreased faster than those of female participants, independent of app use frequency, although women show higher adherence to topical therapy [One of the study’s great strengths was that we were able to show that telemedical care can at least partially replace personal care in patients with hand and foot eczema because the analysis of pictures taken by the patients correlates strongly with that of the in vivo images. Therefore, the HECSI assessed in the face-to-face visit correlated significantly with the eHECSI. This is surely not the case for all dermatological diseases in which the disease can affect the whole body, especially the genital area and the capillitium. A study by Zabludovska et al [Our study includes some limitations. A major limitation is the monocentric design and the small study cohort, which limits generalizability of the results. In particular, the group with <20% app use frequency is very small, which could have led to missed or overinterpreted differences between the groups, especially as we compared this subgroup of the intervention group with the control group. Further studies are necessary to verify our findings on a broader scale.