Improving dermatologic access in shelters: Results from a teledermatology pilot program

Summary: Abstract Body: Unhoused populations often lack access to specialized care, including dermatologic services. Partnerships between dermatologists and free clinics may improve access to care for this underserved population. We evaluated the use and outcomes of a teledermatology program designed to expand access to dermatologic care for individuals experiencing homelessness. A student-run dermatologic clinic partnered with general medicine clinics at two shelters to establish a teledermatology referral program. Healthcare providers were instructed to submit a photo with a brief description for each patient case in which they were requesting guidance. Dermatologists had a 72-hour window to respond, with two medical students serving as liaisons to ensure closed-loop communication. Six teledermatology cases were received from March to August 2024. The median age was 49 years, with 67% male and 33% female. All patients were uninsured; 66% preferred English, and 33% preferred Spanish. The median number of prior general medicine visits for dermatologic concerns was 2. The median turnaround time for consults was 0.5 days (IQR 0-1). Reasons for consult were rash (50%) and moles (50%). Diagnoses included bed bugs, nummular eczema, intertrigo, atypical nevus, congenital nevus, and possible basal cell carcinoma. Topical corticosteroids and antifungals were frequently prescribed for rashes, and two patients with mole concerns were referred for in-person dermatology visits; one followed up and was biopsied and diagnosed with a poroid hidradenoma. The pilot teledermatology program was efficient, with most cases addressed within 24 hours. Future improvements include ensuring follow-up for patients with lesions concerning for skin cancer. * HC and AN contributed equally as co-first authors. Hannah Chang¹, Alejandra Nitsch¹, Shelley Speed¹, Rebecca Vasquez¹ 1. University of Texas Southwestern Medical Center, Dallas, TX, United States. Minoritized Populations and Health Disparities Research