Coronavirus Disease 2019 (COVID-19) represents a global health crisis in which personal protective equipment has become increasingly limited. Dermatologists are poised to use technology, such as teledermatology, to innovate existing workflows and optimize dermatologic care. The state of Ohio has emerged as a leader in the United States with its response to the COVID-19 crisis. In response to the COVID-19 crisis, we developed a simple algorithm and strict guidelines to prioritize telemedicine specifically for inpatient dermatology consults. This algorithm was quickly accepted by our hospital leadership and adopted by other inpatient consultative services. In this Viewpoint, we share our experience with early adoption of teledermatology in the inpatient consultative setting in light of the COVID-19 crisis. We also highlight the limitations, ethical considerations, and areas for future research with respect to the implementation of teledermatology. ARTICLE HISTORY

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Summary Atopic dermatitis (AD) is chronic, pruritic, inflammatory skin disease that affects a significant portion of the population in industrialized nations. For nonresponders to conventional therapies, AD can significantly reduce sleep quality and quality of life. AD pathogenesis is multifactorial and involves multiple immune pathways, with recent evidence of T helper (Th)2, Th17 and Th22 axis attenuation in various AD endotypes and racial subtypes. Inhibition of the conserved Janus kinase (JAK) signalling pathway represents a promising therapeutic avenue to reduce the activation of multiple proinflammatory mediators involved in AD pathogenesis. JAK inhibitors exist in both oral and topical forms with variable specificity for the receptor tyrosine kinases JAK1, JAK2, JAK3 and tyrosine kinase 2. Oral formulations include abrocitinib, upadacitinib, baricitinib and gusacitinib, and are most appropriate for patients with moderate to severe AD. Emerging topical formulation in development include ruxolitinib and deglocitinib, which may be used in patients with localized AD and also adjunctively with systemic therapy in patients with more severe disease. With observed rapidity in itch relief and accompanying dramatic reduction in inflammatory lesion count, JAK inhibitors represent a promising new treatment to revolutionize the management of AD.

Teledermatology refers to the method of delivering health care from a distance using telecommunication technology. 1 With the rise of computer technology and smart phone applications, teledermatology is increasingly functional for health care delivery. Teledermatology may be used in both outpatient and inpatient settings for triage, urgent care, consultations, patient monitoring, and follow-up. A 2015 study found as many as 89% of pediatric dermatologists had experience with teledermatology in their practice and were optimistic about its future use. 2 Likely all pediatric dermatologists now have experience with teledermatology as health care delivery has changed dramatically with the COVID-19 pandemic. Teledermatology has the potential to improve patient access, especially for pediatric dermatology, which is one of the smallest subspecialties in dermatology. As many as 30% of pediatric visits involve a skin complaint. 3 Yet, as of 2020 there were fewer than 400 board-certified pediatric dermatologists in the United States according to the Society for Pediatric Dermatology. 4 In some settings, the wait time for patients to be seen in-person by a board-certified pediatric dermatologist can exceed 100 days. 5 Longer wait times are associated with increased likelihood of patient truancy. 6 Thus, pediatric teledermatology may be used to increase timely access and enhance practice efficiency. 2 | ME THODS We performed a review of the literature of studies regarding pediatric teledermatology. We searched English language articles using PubMed, Ovid MEDLINE, and the Cochrane Library. In combination with the term "pediatric teledermatology," ≥1 of the following search terms were used to obtain articles published in peer-reviewed journals: telemedicine, teleconferencing, telehealth, virtual, videoconferencing, store-and-forward. Referenced studies identified during the search were also included. The review was conducted from April 28, 2020, to September 28, 2020. Articles were evaluated by reviewing their titles and abstracts for relevance. Articles regarding only adult teledermatology were excluded. Thirty-five publications were included.

BackgroundHidradenitis suppurativa (HS) is a chronic inflammatory skin condition that affects the follicular portion of folliculopilosebaceous units. It causes painful nodules, abscesses, and draining sinus tracts throughout multiple regions of the body. HS primarily affects women; the overall HS prevalence in women is three times that in men. Although cutaneous disease itself causes substantial morbidity, recent evidence has shown that HS is a systemic inflammatory disease with multiple associated comorbidities.ObjectiveA review of the literature was conducted to elucidate existing information on this topic to assist in clinical decision-making for dermatologists.MethodsA review of the literature using the PubMed database was conducted with the search term “hidradenitis suppurativa comorbidities”. The search was conducted from March 3, 2019 to March 20, 2019, and yielded 55 articles, case reports, and reviews.ResultsMetabolic and cardiovascular comorbidities were the most commonly associated with HS. HS has a significant comorbidity burden beyond the skin, including metabolic, cardiovascular, endocrine, gastrointestinal, rheumatologic, and psychiatric disorders, which collectively decrease the quality of life of patients.ConclusionsDermatologists should be aware of these associations to encourage appropriate screening and referral for management of these disorders.