Teledermatology has become an increasingly integral component of dermatologic care delivery, improving access and supporting triage for a broad range of skin conditions. Its performance is strongest for inflammatory dermatoses and macroscopically apparent diseases, where standard clinical photography combined with clinical history is often sufficient for reliable diagnosis. However, for neoplastic lesions and conditions requiring structural detail, diagnostic accuracy is more variable and therefore most programs continue to default to in-person evaluation. This review examines the current state of teledermatology practice, the imaging modalities most relevant to its advancement, and the infrastructure required to realize their potential. Dermoscopy represents the most developed and scalable imaging adjunct currently available, though its benefit depends critically on consistent interpretive skill across the range of providers reading teledermatology consultations. The modalities with the most to offer beyond dermoscopy, including optical coherence tomography, high-frequency ultrasound, and total body photography, have well-established diagnostic value in specialized settings but still remain unintegrated in routine teledermatology workflows. This gap exists not because of scientific limitations, but because of an absence of training, standardization, and reimbursement infrastructure needed to deploy them reliably at scale. Realizing their potential will require that infrastructure to mature alongside advances in artificial intelligence, which has an important role in automated image quality assessment, workflow optimization, and ensuring that multimodal imaging data is consistent enough to be clinically interpretable. Progress across all of these fronts must be accompanied by equity-focused research and validation across diverse patient populations because tools that perform inequitably cannot be scaled responsibly. All of this culminates in the proposal of a dermatologic diagnostic imaging center, where trained technologists acquire standardized multimodal studies and remote specialists interpret them from calibrated workstations. This is an achievable vision, and building toward it deliberately is the field’s most important long-term challenge.
Severe cutaneous adverse reactions (SCARs) are associated with significant morbidity and mortality; however, the optimal therapeutic approach remains uncertain. This review will highlight emerging data surrounding the use of targeted inhibitors for the treatment of drug reaction with systemic symptoms (DRESS) syndrome and Stevens Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN). Novel agents, including targeted inhibitors of interleukin-5 (IL-5), interleukins 4/13 (IL-4/13) and the JAK/STAT pathway, have demonstrated utility in the treatment of SCARs. Larger prospective studies are needed to further establish efficacy, define patient selection, clarify dosing, and delineate safety. Additional work is necessary to determine the ideal therapeutic approaches for DRESS and SJS/TEN, though novel therapeutics show promise in case reports and series.
Skin diseases are a common cause of hospitalization and contribute substantially to healthcare utilization, patient morbidity, and healthcare expenditures. Despite evidence supporting specialist involvement, most hospitalized patients with dermatologic conditions are managed without dermatology consultation. This review examines the evolution of inpatient dermatology services and evaluates their impact on diagnostic accuracy, patient outcomes, healthcare utilization, and costs. Across prospective and retrospective studies, dermatology consultation has been associated with diagnostic and therapeutic revisions in many cases. Specialist involvement has been linked to shorter hospital stays, lower readmission rates, improved treatment selection, and high levels of patient and provider satisfaction. These clinical benefits translate into substantial economic value, with analyses demonstrating significant healthcare savings and favorable returns on investment despite relatively low utilization of consultation services. The review also highlights the ongoing contraction of inpatient dermatology services and the resulting gaps in access. Teledermatology has emerged as a promising strategy to extend specialist expertise to underserved hospitals and patient populations, demonstrating high diagnostic concordance with in-person consultation and positive patient acceptance. The literature surrounding cellulitis serves as a particularly compelling example of the value of inpatient dermatology consultation, illustrating how specialist involvement can reduce misdiagnosis, unnecessary hospitalization, antibiotic overuse, and healthcare spending. Collectively, the evidence suggests that inpatient dermatology consultation represents a high-value service that remains underutilized in contemporary hospital practice. Future efforts should focus on developing standardized consultation pathways, expanding teledermatology infrastructure, and aligning reimbursement models with the demonstrated clinical and economic benefits of specialist dermatologic care.
The inpatient dermatology service provides a clinically rich environment for medical education across multiple learner levels, yet systematic guidance on teaching in this setting remains limited. This review summarizes evidence-based best practices for teaching in the inpatient dermatology consult setting. Structured teaching frameworks including the One-Minute Preceptor and SNAPPS have demonstrated effectiveness in clinical education settings and are well suited to the demands of inpatient dermatology teaching. Bedside teaching remains the primary modality for morphologic education and is most effective when combined with active learner involvement and focused debriefing. Case-based learning and chalk talks, integrated with spaced repetition, promote knowledge retention. Effective feedback requires specificity and an educational alliance between supervisor and trainee. The consultative encounter provides an important opportunity for interspecialty education through transparent communication of diagnostic reasoning and point-of-care teaching. Formal resident-as-teacher programming may also increase residents’ knowledge of and confidence in teaching techniques. Effective teaching in the inpatient dermatology setting requires intentional effort from educators at all levels. Evidence-based strategies including structured teaching frameworks, bedside instruction, case-based learning, and formal resident-as-teacher programming can be incorporated into existing clinical workflows without requiring significant additional resources or protected time. Dermatologists who approach both team-based and consultative teaching deliberately are well positioned to improve dermatologic education across specialties and training levels.
This report focuses on oral findings the inpatient dermatologist may encounter when managing patients with a history of solid organ transplantation. While oral ulceration most commonly represents a benign etiology in healthy patients, solid organ transplant recipients (SOTRs) represent a population with increased baseline risk to oral ulceration that not only carry a negative impact on quality of life but also may signify serious underlying etiologies such as disseminated infection or malignancy. A literature review within the last 3 years has increased insight into the etiologies contributing to this condition, as well as the detrimental impact of oral ulceration on quality of life in this patient population. We aim to provide a review of the history, epidemiology, clinical course, diagnostic pearls, and management when encountering oral ulcerations in SOTRs.
