LAUSR

Background The spectrum and magnitude of changes in dermatology practice induced by the COVID-19 pandemic have not been adequately studied. Objectives To assess immediate and long-term effects of the pandemic on dermatology practice on a large scale, including the clinical activity of participant, frequency and types of procedures used, and teledermatology (TD) use. Methods This web-based, global survey included 733 dermatologists. Primary outcomes are percentages of responders providing in-person consultations, hospital service, and TD, and doing procedures. Also, factors in logistic regression models that may influence the Odds Ratio (OR) for TD use during pandemic and for future use. Results The percentages of responders providing in-person consultations (46.6% vs 100% before), and hospital service (27% vs 52.8% before), and doing procedures (25.6% vs 100% before) decreased while practicing TD increased three-fold (75.2% vs 26.1% before) during pandemic (P < .001 for each). Practice location was associated with TD use during the pandemic and with its expected use in the future (P < .001 for both), with North American responders indicating the highest use. TD use during the pandemic showed a positive correlation with TD use before, performing procedures and, more specifically, with biopsies of suspicious pigmented lesions during pandemic (P < .001 for each). TD use before pandemic was the most powerful predictor of TD use during pandemic (OR, 16.47 [95% CI, 7.12-38.06]). More than two thirds (68.6%) of participants expect to use TD in the future. The factor with the largest increase in OR on the expectation of future TD use was >1,000 COVID-19 cases in the country (OR, 3.80 [95% CI, 2.33-6.21]). Conclusions This survey indicates a profound immediate effect of the pandemic on dermatology practice. The pandemic appears to have substantially contributed to an increased use of TD in the long-run.