Can chronic recurrent dermatoses be managed through augmented virtual reality?

With the advancement of technology in the medical field, the metaverse is an emerging, groundbreaking technology, proving its worth in transforming dermatology, especially in managing chronic recurrent dermatoses.¹ This digital revolution is a crucial entity in future dermatology interactions with patients who are reluctant or conscience-stricken to consult physically, especially in chronic recurrent dermatoses. Moreover, such diseases, such as chronic dermatophytosis, chronic plaque psoriasis, and chronic eczema, have significant psychosocial challenges where the metaverse presents a distinctive opportunity to amplify patient care, counselling, and disease education.

The metaverse is an amalgamation of augmented reality (AR), virtual reality (VR), and artificial intelligence (AI), which creates a 3D environment through which the patient may communicate unresistingly and therefore be managed and counselled effectively.² The metaverse is a broader concept, and it will undoubtedly transform teledermatology, making virtual consultations more immersive and interactive. Currently, teledermatology relies on video conferencing tools like Zoom, Google Meet, which can limit communication and patient assessment. The metaverse, however, allows healthcare providers and patients to interact in a more natural and engaging manner, simulating in-person consultations. Patients with chronic recurrent dermatoses are lost to follow-up from physical consultations in lieu of lost work hours in visiting the health facility. Patients can now interact with dermatologists within a virtual space, sitting at their places, even miles away from a health facility. Hand lens or dermatoscope visualisation can now be done virtually for detailed examination through the metaverse. A virtual trichoscopy on a patient with androgenetic alopecia demonstrated promising early results in visualising hair density, but still ultimately required follow-up with in-person imaging for confirmation.³

In addition to virtual consultation and examination, AI-powered avatars are changing the course of management through effective counselling by simulating patients and proclaiming the progress of the chronic recurrent dermatoses such as erythroderma arising from dermatophytosis, psoriasis, endogenous eczema, or ulceration and disability arising from chronic recurrent erythema nodosum leprosum reaction. This precludes the need for physical counselling for the sake of adherence to the treatment and compliance, which is important in these chronic illnesses. In a pilot study by Chang et al., metaverse may aid in shared decision making (SDM) in children with moderate to severe atopic dermatitis through designing a multimedia mixed reality (MR) interactive game.⁴

Nowadays, the metaverse also provides access to join virtual communities which are involved in supporting patients and share their experiences. This activity motivates the patients and breaks the shackles of psychosocial curtailment arising from the disease. Patients can also be involved in group discussions, attend workshops, or find answers to the queries through this innovative platform.

Apart from patients, caregivers (dermatologists) can enhance their skills by participating in virtual sessions and workshops, augmenting their knowledge and expertise in the field. The 3D environment through VR may give insight into the examination and hands-on experience, which enhances medical as well as surgical skills.

The use of innovative technology, like in other medical and surgical fields, proving its merit, dermatology, being a specialty based on virtual assessment, may prove to be a boon, especially in diseases that are chronic, recurrent, and require multiple visits to a health facility, and to those patients who live far from the place of a specialised health facility. However, like an idiom, there are two sides to a coin; the metaverse has its own limitations. The access to VR gadgets in resource-poor settings, cost associated, high-speed internet, and audio-visual data privacy, safe and ethical usage are its shortcomings, which may put a few inherent hurdles in the path of this innovative technology.⁵ Trust building in the technology may be possible by ensuring robust cybersecurity and easy access to the AI-based augmented and virtual reality.