BT26 Apps and web-based tools to use in dermatology practice

Abstract There is a growing trend towards paperless clinical practice. Apps and web-based tools can help to quickly capture useful clinical information to influence management. We reviewed free digital dermatology tools that are available for clinicians with the goal of promoting awareness of these resources. We conducted a PubMed literature search and searched the Apple App Store using key search terms. We found that web-based platforms or apps available with a dermatological theme that can aid clinical practice can be summarized and categorized into the following four groups. (i) Disease-specific severity assessment in alopecia areata (AASI), atopic eczema (eSCORAD, eEASI, POEM, vIGAAD), melasma (MASI), psoriasis (ePASI), nail psoriasis (NAPPA-QOL), acne (ePGA), hidradenitis suppurativa (HS-PGA, IHS4, eSartorius, eHurley), chronic urticaria (UAS7, UCT), pressure ulcers (Braden scale), toxic epidermal necrolysis (eSCORTEN), symptom severity assessment in pruritus (PNRS, pruritus VAS), pain (ePain VAS, Neuropathic Pain Scale), obesity (body mass index calculator), leg ulcer (eWoundQoL score) and assessment of quality of life in any skin disorder (eDLQI). Also, staging of skin cancers like melanoma (eTNM) and squamous cell carcinoma (AJCC8, BWH), and estimating survival and risk prediction in melanoma positive sentinel lymph node biopsy, recurrence, first primary, second primary, immunotherapy outcome prediction (MIA, SweMR). (ii) As an aid to diagnosis in Behçet disease, DRESS (RegiSCAR), psoriatic arthritis (DAPSA, CASPAR), scleroderma (RODNAN), systemic lupus erythematosus (EULAR-ACR, SLICC criteria, SLEDAI), necrotizing fasciitis (LRINEC score) and cellulitis (ALT-70) ; and for depression screening (ePHQ9), suicidality screening (ED-SAFE PSS-3), anxiety screening (GAD-7), excess alcohol consumption (AUDIT-C, CAGE), HIV risk screening (Denver HIV score), predicting life expectancy (Charlson Comorbidity Index), Clinical Frailty Score, mental state (AMT-10) and noninvasive estimate of liver cirrhosis (FIB-4 Index, NAFLD fibrosis score). (iii) To help inform decisions related to skin surgery: decision to stop or continue an anticoagulant before skin surgery (HASBLED), stroke risk in atrial fibrillation (CHA2DS2-VASs score), and a local anaesthetic dosing guide. (iv) For assistance in prescribing: electronic British National Formulary, systemic steroid conversion, hydroxychloroquine maximum daily dose, and Geneva score – inpatient venous thromboembolism prophylaxis. We found the following resources especially useful – MDApp, Dermascore, Dermatools, Dermavalue, MDCalc and the Melanoma Institute of Australia risk prediction tools; these require manual input or selection of relevant data from dropdown lists, enabling the program to calculate the final score. In our experience, use of digital resources facilitates processing of relevant clinical information quickly and efficiently, helping in patient engagement and thorough assessment. We propose that the British Association of Dermatologists could develop a ‘one-stop’ app with multiple scoring tools for dermatologists to use in clinical practice.