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Background Telemedicine is a worldwide healthcare practice that, during the last years, has dramatically reduced the time of consultation for patients. Teledermoscopy aids in the current management of skin cancers in general and particularly of melanoma; telemedicine and teledermoscopy give the chance to provide consultations with experts also by long distance. Objective The purpose of this study is to determine the diagnostic reliability, according to interobserver agreement, between clinical and dermoscopic diagnosis of lesions with poor and/or absent pigmentation, comparing face-to-face diagnosis and telediagnosis. Materials and methods Forty-four lesions were examined by two different dermatologists with good and similar experience in the clinical field and dermoscopy. A store-and-forward teledermatological system, based on clinical and dermoscopic images, was done by the two skilled dermatologists. Results Our results underline that teledermoscopy of ‘pink’ lesions does not provide a similar degree of diagnostic accuracy as otherwise in face-to-face diagnosis perhaps due to the absence of typical criteria. Atypical skin lesions are characterized by the absence of typical dermoscopic patterns, and their teleconsultation does not always increase the diagnostic accuracy.

Aim. Adverse drug reaction (ADRs) monitoring is useful tool for the determination of the negative side effects of drugs from the ethical and practical points of view. It is also a guide to their safest and most efficient use with the aim of improving the quality of healthcare. In addition to their effect on human health, ADRs also impact significantly on healthcare costs. Since ADRs present most frequently with cutaneous signs and symptoms, patients are often referred to dermatologists, who thus come to play a fundamental role in the detection and diagnosis of these reactions, as well as in patient management. Methods. Epidemiological data of 649 patients admitted to the Department of Dermatology of University of Naples Federico II for suspect ADRs were examined. Results. Amongst the ADR identified in our cases, the most frequently observed cutaneous and extracutaneous manifestations were urticaria-angioedema (62%), maculopapular rash (21.4%), loss of consciousness (4.2%), dyspnea (3.7%), anaphylactic shock (2.5%), nausea (1.8%), itching (1.5%), stomatitis (1.1%), Stevens-Johnson's syndrome (0.6%), paraesthesia (0.3%), erythema nodosum (0.3%), fixed eruption (0.3%), epistaxis (0.3%). ADRs were more often triggered by the following therapeutic categories: antibiotic agents (45%), antipyretic and analgesic drugs (23%), non steroidal anti-inflammatory drugs (28%). Conclusion. The widespread use of these drugs justifies the importance of drug-surveillance activity, aimed at decreasing the negative effects of liberal drug use and at increasing their safety.