In this issue González Coloma et al1 analyze the use of teledermatology as a solution to the problem of access to specialist care in the province of Palena, Chile, where primary care clinics attend a large number of patients seeking care for skin conditions. The province's population is widely dispersed over a large geographic area, and access to a dermatologist through the public health care system is difficult because specialists are concentrated in centrally located cities. The authors report their cross-sectional study of the use of a teledermatology system, in particular the level of agreement between the diagnoses at the primary care clinics and at the referral hospital where the dermatologist was available. Agreement was moderate, somewhat lower than in similar studies.2 The significant difference between the rates of specialist and nonspecialist diagnoses of inflammatory skin diseases suggest a need for better training of primary care physicians in this respect. The authors also saw a very large reduction in response time (until a specialist diagnosis was reached) when a dermatologist was contracted at the referral hospital as opposed to attending cases there on a part-time basis. The results suggest a clear need for specialist staffing. Response time was also shorter when direct physical examination by the dermatologist at the referral center was not required. This study shows how teledermatology can resolve a significant proportion of the skin conditions seen by primary care practitioners, reducing costs and time until diagnosis for patients who reside in isolated rural areas that lack specialists.