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Background Dermatological lesions are a common extra-intestinal manifestation (EIM) associated with inflammatory bowel disease (IBD) or its treatment. The severity of the lesions requires a preferential assessment by the dermatologist. The photography allows a telematic evaluation and non-face-to-face analysis. There are no published experiences of telemedicine in patients with IBD and dermatological EIMs. This study aimed to assess the results of a telematic system for the evaluation of dermatological lesions in patients with IBD (TELEDERMA) developed between the Dermatology Department and IBD Unit. Methods The retrospective study that evaluates this system from its implementation in June 2014 to December 2017 (3.5 years). TELEDERMA (TD) establishes the issuance of a telematic consultation with images through electronic clinical history. A therapy is advised by a dermatologist either through an electronic prescription or a personal appointment. The study evaluates the average time of the telematic consultation, type of lesion and attitude of patients towards the therapy, type and characteristics of the IBD, treatments applied, other EIMs, smoking and dermatological history. Patients were asked to describe and evaluate their level of satisfaction. Results A total number of 47 consultations from 39 patients (70% females) with an average age of 33.2 (8–75) have been made.41 of these consultations were made in patients with Crohn Disease (CD) and 6 in patients with ulcerative colitis (UC). Sixty-seven per cent of the patients with UC had pancolitis. CD Patients had ileal o ileocolonic location (82%) with inflammatory (39%) and stricturing (55%) behaviour. Eighteen per cent of the patients had an active flare-up. 1 out of every four patients had other EIMs. The most frequent reason for teleconsultation was paradoxical psoriasiform lesions (n = 13, 33.3%) of anti-TNF agents (70% of the patients) and suppurative hidradenitis (n = 4, 10.3%). The resolution was achieved in 87%, and only one patient had to interrupt the anti-TNF therapy. The average waiting time was 4.7 days (0–14), compared with the 60 and 28 days of the current waiting list with a routine or preferential request, respectively. All the patients evaluated this system positively, highlighting the advantages of rapidness in both the resolution of the consultations. Conclusion TD is a useful tool for the rapid assessment of dermatological lesions associated with IBD. It prevents the patients from going to the emergency department, improves the care quality and the degree of satisfaction of the patients. The most frequent teleconsultations were related to psoriasiform lesions associated with anti-TNF therapy. The interruption of treatment was exceptional.

Background The incidence and prevalence of Inflammatory bowel disease (IBD) are increasing in the last years. In primary care (PC) patients often present with confusing and non-specific symptoms which can often be a delay in referring and diagnosing suspected IBD. The average time from symptom onset to diagnosis of IBD is longer than five years in up to 18% of cases and 64% of patients presenting to emergency care with symptoms of IBD prior to the diagnosis. Shared care protocols and closer working with integrated care teams can bridge the gap between primary and specialized care, improving their assistance Methods This is a retrospective study that evaluates the results of TELEIBD (telematic circuit care) in patients with high diagnostic suspicion of IBD between PC and IBD Unit of our health area since its implementation in August 2019 to October 2020. The number of telematic consultations, average resolution time, adaptation to referral criteria, complementary tests requested and diagnostic confirmation were evaluated. TELEIBD establishes the issuance of a telematic consultation through the electronic clinical history when a patient meets previously established criteria. Specialized IBD physician who evaluates the case, can advise a diagnostic or therapeutic attitude either by electronic means or face-to-face with the patient. Results A total number of 77 care consultations from 77 patients (58,4% females) have been made. The average age was 49,2 years and the average reponse time were 7,5 days. After teleconsultation, 46 patients (59.7%) were not requested medical test. Lower gastrointestinal endoscopy (LGE) was performed in 25 patients, blood and faecal calprotectin testing in 7 patients, magnetic resonance (MR) or computer tomographic (CT) enterography in 6 patients. Taking into account the criteria for referral to a specialist, a total of 15 patients (19,5%) fully met the criteria, 13 patients (16,9%) partially met the criteria and 49 patients (63,6%) did not meet it. The main reason fot not meeting the criteria were the inadequated use of TELEIBD (53,1%). Of the 25 LGE requested, 3 were suggestive of Ulcerative Colitis (UC) and 1 of Crohn’s Disease (CD). Diagnosis of CD was confirmed in 2 patients, using MR or CT enterography. Diagnoses were reached in 4 patients, 3 of the group that met referral criteria (20%) and 1 of the group that partially met it (7.7%). The diagnosis was not achieved in any patient who did not partially and/or fully meet the referral criteria. Conclusion TELEIBD can be a useful tool for the quick assessment of patients who meet the criteria for high suspicion of IBD. Training primary care physicians in the referral criteria of the pathway is essential to improve the functioning of the circuit.