Presto — consultant-grade dermatology letters

Try it instantly

No account needed — tap a sample below and watch it write a full consultant-grade letter. (Demo letters are stamped “DEMO — not for clinical use.”)

Your signature (closes every letter — your sign-off, name & credentials)

Consultation letter style (new consult letters; switch any letter with the ⇄ chip)

Plan depth (management-plan detail; safety is never trimmed; flip on any letter)

Default document type (what a new patient starts on) Prescriptions (the copy-ready lines beneath each letter) Include patient warnings when copying prescriptions Append prescriptions to letter (Copy letter adds them under a "Prescriptions" heading, before the sign-off)

Teach the engine YOUR style per document type. Styles are saved to your account and follow you to any device. Remove patient names and identifiers first — only your writing style is kept, never patient details.

1Pick the document type

2Paste one or two de-identified examples

3Learn it

Upload .txt

Learned style (edits save on their own)

Dictation runs on this computer. Your audio never leaves it. The dictation engine is downloaded once into this browser and works without an internet connection afterwards. Nothing you say is stored — the words exist only in the shorthand box.

Dictation model Auto picks a model that suits this computer — Standard on most PCs, Best on Apple-silicon Macs.

Engine: not started yet.

Microphone Hold Ctrl to dictate; release to stop (the Dictate button always works) Stop listening by itself after a minute and a half of silence Always write it this way Your own vocabulary — never patient details. Stays in this browser.

Nothing yet. When you correct a dictated word in the box, Presto offers to remember it — or add one here.

Dictation log This session only — engine steps, and phrases it left out and why. Nothing is stored.

Nothing yet.

If dictation won’t start on this device — no patient data, just the browser, the steps reached and the error.

EMR insertion lives in the Chrome/Edge extension. On your clinic computer, the extension connects to your EMR and types the finished letter straight into the note box — this web app is for writing and copying anywhere. The desktop companion's pairing will live here when it ships.

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Presto learns your preferences — never patient facts — and only for your account. A learned answer is offered as a highlighted chip; you confirm it on every letter.

Questions per letter (patient-fact questions always fit first)

Your usual answers (offered, never assumed)

Questions you skip (no longer asked for that diagnosis)

Service address (pre-set for you — only change this if you're told to)

Not tested yet

1Clinical shorthand

Examination & plan — physician

How Presto works

Type the way you think between patients — it writes the finished letter. It handles any dermatology presentation; the examples below are just to get you started.

The shorthand key

Ex:what you examined Dx:dermoscopy (Dx typical = classical findings) Mx:your plan (Mx usual = the full standard plan) diff / vssuggest or weigh differentials ( … )an instruction to Presto [ … ]a blank you fill in later full stopstarts a separate problem /name␣drops one of your saved templates /handoutswitches to a patient handout /fuswitches to a follow-up letter (so does f/u at the very start)

Example — 31F, alopecia patch occiput 3wk, NKDA. Ex: 3x2cm patch. Dx: exclamation-mark hairs. Mx: ILT Kenalog 6mg/ml, r/v 6wk.

Examples to try — tap one to fill the box

Save as my template

Keyboard shortcuts

Ctrl/Cmd + Entergenerate the document

Ctrl/Cmd + .Fast ⇄ Comprehensive

Ctrl/Cmd + 'Essential ⇄ Academic plan

hold Ctrldictate while held

/name + spacedrop a saved template

Enter / Escadvance / skip the quiz

Ctrl/Cmd + Shift + Ccopy all prescriptions

2Document type

3Draft depth

4Finished document

Copied — now paste it into your chart (⌘V / Ctrl+V). Works in any EMR, including Citrix-delivered systems. On OSCAR? The Presto extension inserts it into the note with one click — learn more.

Refine

Prescribeadds a detailed item per medication to the plan

Reviserefine the whole letter in plain English