AN ONLINE, team-based connected health (TCH) model can provide similar improvements in atopic dermatitis (AD) severity and symptoms compared with traditional in-person dermatology care, according to a new randomised clinical trial.
The study investigated whether digital care could offer a scalable alternative for children and adults with AD, a chronic inflammatory skin condition that often requires ongoing specialist management. Researchers highlighted the need for accessible care models that connect patients, primary care clinicians and dermatologists, particularly for those facing geographical or healthcare access barriers.
The trial included 300 patients with AD, aged from one year upwards, recruited from eight outpatient dermatology clinics in California between 2019 and 2024. Participants were randomly assigned to either receive online TCH care or conventional in-person dermatology visits.
Online Care Model Achieved Comparable Improvements
Patients in the online care group received asynchronous access to dermatologists, who reviewed clinical information and photographs before providing assessments and treatment recommendations. Outcomes were compared with patients receiving standard face-to-face care over 12 months.
The primary measure was change in the Eczema Area and Severity Index (EASI), alongside secondary assessments including the Patient-Oriented Eczema Measure (POEM) and validated Investigator Global Assessment (vIGA).
Researchers found no meaningful differences between the two groups. The difference in average EASI improvement between online and in-person care was −0.01, with results falling within the predefined range required to demonstrate equivalent outcomes.
Similarly, differences in POEM and vIGA scores remained within equivalence margins, indicating that online management achieved comparable improvements in both patient-reported symptoms and clinician-assessed disease severity.
Digital Dermatology May Improve Access to Specialist Care
The findings suggest that online dermatology models could help expand access to effective AD management while maintaining clinical outcomes. This may be particularly valuable for patients who experience difficulties attending frequent specialist appointments due to location, mobility, or healthcare availability.
The researchers concluded that team-based connected health models represent a promising approach for managing chronic inflammatory skin diseases such as atopic dermatitis.
Further studies may help determine how digital care can be integrated into routine dermatology services and identify which patients may benefit most from remote management strategies.
Reference
Armstrong AW et al. Online vs in-person care for atopic dermatitis: a randomized clinical trial. JAMA Dermatol. 2026;DOI:10.1001/jamadermatol.2026.1959.
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