Improving Remote Dermatology Care, Diagnosis, and Clinical Trial Diversity: James Song, MD

This content was developed independently and is not endorsed by the American Academy of Dermatology.

Teledermatology is becoming a key part of dermatologic care, especially for patients who need frequent monitoring but struggle to attend in-person visits, according to James Song, MD, chief medical officer and director of clinical research, Frontier Dermatology. He notes that virtual care works particularly well for follow-up appointments, such as monitoring patients on isotretinoin, where the focus is on safety checks and prescription renewals.

However, telemedicine is not suitable for every dermatologic concern. Song emphasizes that current technology is not yet reliable enough to diagnose pigmented lesions or skin cancers remotely, though this may change as imaging and diagnostic tools improve. For now, teledermatology is best used for follow-up visits in patients who are doing well on therapy and mainly need prescription renewals or brief check-ins.

Insurance coverage remains a critical barrier. During the COVID-19 pandemic, many payers reimbursed telemedicine at parity with in-person visits, but some have since reduced coverage or eliminated it altogether. Therefore, it is important to advocate to ensure patients do not lose access to these valuable services.

Additionally, Song highlights disparities in how skin conditions present across different skin tones. Although the underlying biology is the same, diseases may look different in patients of color, leading to delayed diagnoses and suboptimal treatment. Gaps in clinician training and the underrepresentation of patients of color in clinical trials further limit the availability of evidence-based care. Encouragingly, more pharmaceutical companies are now investing in trials that include diverse skin tones, a shift that promises more equitable and accurate dermatologic care.