The use of teledermatology in primary care has been shown to be reliable, offering the possibility of improving access to dermatological care by using telecommunication technologies to connect several medical centers and enable the exchange of information about skin conditions over long distances. This paper describes the main points of a teledermatology project that we have implemented to promote and facilitate the diagnosis of skin diseases and improve the quality of care for rural and remote areas. Moreover, we present a blockchain-based approach which aims to add new functionalities to an innovative teledermatology platform which we developed and tested in the Sardinian Region (Italy). These functionalities include giving the patient complete access to his/her medical records while maintaining security. Finally, the advantages that this new decentralized system can provide for patients and specialists are presented.