Abstract
Objective: To determine the clinical patterns and outcomes of skin diseases with real time tele- dermatology in remote areas of Pakistan.
Methodology: Eighty patients registered during 2014-2017 at primary care center at Gilgit-Baltistan were included in the study. They were initially attended by a medical officer for history and clinical assessments then were examined via video link by the dermatologists in Karachi, using high-resolution camera. Diagnoses were made and management plan given accordingly. Patients were requested to follow-up in four weeks. Data regarding age, gender, diagnoses and condition upon subsequent visits was recorded.
Results: Out of 80 patients, 38 were male and 42 females with mean age 27.2 years. The most common diagnoses were eczema (13.8%), acne (12.5%) and melasma (11.3%). Thirty patients were lost-to-follow-up. Forty-four (88%) out of the rest of the patients reported improvement of symptoms. No significant correlation was found between failure to follow up and age and gender of patients. Age and gender of lost to follow up patients were not statistically significant.
Conclusion: Real time tele dermatology can be utilized as a substitute for face to face (FTF) encounters for the management of skin diseases. This is helpful for patients located in distant resource-limited areas. There is, however, a dire need of planning, execution as well as funding resources at national/international level to implement this service.

Key words: Real-time, Tele dermatology, eczema.