Caring for an autoimmune patient during a pandemic
Telemedicine allows a dermatologist to care for a melanoma survivor with a rare autoimmune condition during the COVID-19 pandemic.
Jennifer Bowers' story
I’m fair-skinned with freckles and red hair. I grew up in the 1970s when sunscreen was not yet widely used, and I was sunburned countless times as a kid.
Just six months after my regular skin check with dermatologist Dr. Janet Lin, where everything looked normal, my husband noticed a spot at the top of my back. Dr. Lin’s follow-up biopsy revealed melanoma, and given the size and depth of the lesion, she referred me to a melanoma specialty clinic.
Dr. Lin was on the phone with the specialty clinic the same day I went in for the visit to ensure my care experience was seamless. The coordination between her and the specialty clinic was incredible. I’m an oncology nurse, so I know that level of coordination is not always guaranteed.
My team at the clinic included an oncologist, dermatologist, and surgeon who all specialize in melanoma, as well as a plastic surgeon, who was luckily able to close the large excision without a skin graft. After two lymph nodes tested positive for cancer cells, I began a year of immunotherapy infusions.
Shortly after I finished the immunotherapy, I developed severe sores in my mouth, followed by a rash. I was diagnosed with erythema multiforme major, an autoimmune condition likely caused by the immunotherapy treatment.
I began self-isolating in January 2020 because of my compromised immune system, before COVID-19 was a widespread concern in the United States. My check-ins with Dr. Lin are now virtual as she tapers me off the steroids I take to control the autoimmune condition, which she and I hope will eventually subside. I am incredibly grateful that Dr. Lin quickly transitioned my care to telemedicine. Given my compromised immune system, if Dr. Lin weren’t able to provide effective care remotely, I don’t know how I would safely get the treatment I need during the coronavirus pandemic, which looks likely to last months if not longer. But as a nurse, I’m also frustrated that I can’t help during this crisis. I see my friends, colleagues, and family putting their lives on the line every day to fight COVID-19. It breaks my heart that I can’t do the work I trained for by helping others in their time of need.
The dermatologist's perspective
“It’s important for primary care and specialists to see patients like Jennifer via telemedicine during the COVID-19 crisis. It ensures patients receive the care they need, reduces the spread of the virus, and reserves hospital capacity for patients with the coronavirus and those who need other emergency care. Dermatologists have long been leaders in telemedicine, so we’re well-positioned to continue our regular work virtually. I’m proud to do my part.”
─ Janet Lin, MD, FAAD, DermAssociates
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