Nurse-Led Triage, Education Could Expand Dermatology Access

Dermatology workforce shortages continue to limit timely access to specialty care, particularly in rural and underserved communities where patients may wait weeks or even months for an appointment. A recent systematic review by Kimberly Madison, DNP, AGPCNP-BC, WCC, founder of Mahogany Dermatology Nursing Education and Research, and Jade Trevino, BSN, RN, founder of Go Skin Check mobile dermatology service, found that AI-assisted dermatology technologies integrated with teledermatology platforms consistently shortened wait times, often to fewer than 30 days, while supporting safe task shifting and expanded access to care. In a recent interview with Dermatology Times, the authors discussed how nurses could play a larger role in those evolving care models.¹²³

Melanoma Nurses and Task Shifting Models

Trevino pointed to nurse-led melanoma assessment programs already operating in Australia and New Zealand, where specially trained nurses independently evaluate lesions suspicious for skin cancer before directing patients to appropriate dermatology care. She said the model demonstrates how task shifting, delegating selected clinical responsibilities from physicians to appropriately trained nurses, can improve access while ensuring patients with the greatest need receive timely specialist care.³

These nurses work autonomously in the community and clinics, and they are specially trained to assess and triage patients who have lesions or spots that are highly suspicious to be skin cancer or melanoma — Jade Trevino, BSN, RN,

Trevino noted that similar task-shifting models already exist in the United States through aesthetic medicine, where registered nurses routinely provide treatments such as botulinum toxin and dermal fillers following appropriate training. She suggested that expanding comparable educational pathways in dermatology could similarly improve patient access while maintaining quality of care.³

The interview echoed findings from Madison and Trevino's systematic review, which evaluated 32 studies published between 2019 and 2024. The review found that AI-assisted teledermatology platforms consistently reduced dermatology wait times, streamlined referrals, and supported safe task shifting to nondermatologist clinicians, particularly in underserved communities where specialist access is limited.

Nursing Already Owns the Skin

Madison argued that dermatology is a natural extension of traditional nursing responsibilities because skin assessment is already embedded throughout nursing practice. “Nursing owns the skin” She said. However, she said nursing education often emphasizes integumentary care, wound management, and incontinence rather than dermatologic disease recognition, leaving an opportunity to strengthen dermatology-specific education.³

Madison said nurses can contribute more detailed skin documentation, educate patients while they await dermatology appointments, explain available therapies and potential adverse effects, and help patients prepare for specialist visits. She added that dermatologists' limited time is often best reserved for patients with moderate, severe, or rare skin diseases, while appropriately trained nurses can provide education and support for patients with less complex conditions.

The review also highlighted registered nurses as the largest segment of the US healthcare workforce, suggesting they are well positioned to contribute to dermatology triage, patient education, and early assessment if supported by additional dermatology-specific training and evidence-based care models.

Education, AI, and the Future of Nurse-Led Triage

Madison said expanding dermatology education for nurse practitioners could further improve access to care. She noted that NPs without formal dermatology training can begin by managing straightforward cases while patients wait for specialty appointments and gradually expand their clinical responsibilities through continuing education, conferences, mentorship, and experience.3

Madison emphasized that AI should function as a clinical decision-support tool rather than a replacement for clinician judgment. Their review found AI can improve diagnostic confidence by providing differential diagnoses, confidence scores, and visual explanations that help clinicians identify concerning lesions, support referral decisions, and improve access without replacing dermatologist oversight.

As an example of nurse-led innovation, Madison highlighted AfriDam AI, a dermatology platform developed by Nigerian nurse Obey Ezekiel. She said the system was trained using approximately 40,000 images representing diverse skin tones to help identify potential skin conditions before connecting patients with a dermatologist for evaluation.⁴

That's a nurse helping triage, decrease wait times, and get you access to a dermatologist — Kimberly Madison, DNP

Madison and Trevino emphasized that nurses are intended to complement—not replace—dermatologists. Their review concluded that AI-assisted technologies are most effective when paired with clinician oversight, allowing nurses, primary care clinicians, and dermatologists to work together to streamline referrals, improve access, and reserve specialist visits for patients with the greatest need. The authors also identified nurse-led AI triage models and real-world implementation in underserved communities as important priorities for future research

REFERENCES:

1. Go Skin Check. Accessed July 27, 2026. https://goskincheck.com/
2. Mahogany Dermatology Nursing Education and Research. Accessed July 27, 2026. https://www.mahoganydermatology.com/
3. Madison K, Trevino J. AI-assisted dermatology in provider shortage areas: a systematic review of access and wait time outcomes. J Clin Aesthet Dermatol. 2026;19(5-6 Suppl 1):S16-S23. Accessed July 27, 2026. https://jcadonline.com/ai-assisted-dermatology-in-provider-shortage-areas-a-systematic-review-of-access-and-wait-time-outcomes/
4. Afridam AI. Accessed July 27, 2026. https://afridamai.com/