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. 2021 May 12;12(3):417-422.
doi: 10.4103/idoj.IDOJ_555_20. eCollection 2021 May-Jun.

A Retrospective Study to Evaluate the Impact of In-Patient Dermatological Consultations on Diagnostic Accuracy in a Tertiary Care Setting

Keshavamurthy Vinay  1 , Vishal Thakur  1 , Rajat Choudhary  1 , Anubha Dev  1 , Debajyoti Chatterjee  2 , Sanjeev Handa  1
Affiliations

A Retrospective Study to Evaluate the Impact of In-Patient Dermatological Consultations on Diagnostic Accuracy in a Tertiary Care Setting

Keshavamurthy Vinay et al. Indian Dermatol Online J. .

Abstract

Background: Dermatology is primarily an outpatient specialty. However, dermatology consultations play an important role in care of inpatients. Data on inpatient dermatological consultations in tertiary care settings is limited.

Objectives: To evaluate clinical characteristics of inpatient dermatological consultations and effect on clinical outcomes in a tertiary care setting.

Methods: This was a single-center retrospective study where the records of all dermatological consultations for patients admitted under various specialties, emergency services, and intensive care units (ICU) at our tertiary care institute over 2 years period were reviewed. The details of patients, primary care unit, dermatological complaints, diagnosis, investigations performed, treatment given, and follow-up were recorded and analyzed.

Results: Total of 1717 dermatologic consultations (1000 males) were recorded, with mean age of study population being 33.6 ± 21.6 years (median - 32 years). Out of total 1717 patients, 136 (7.9%), 321 (18.7%), 1135 (66.1%), and 125 (7.3%) patients were infants, children, adolescents, adults, and elderly, respectively. The most frequent diagnostic group was infective diseases (586; 34.1%) followed by inflammatory diseases (442; 25.7%), mucocutaneous adverse drug reactions (160; 9.3%), and autoimmune diseases (65; 3.8%). Primary team's diagnosis was concordant with the dermatology consultation in 1112 (64.8%) patients and discordant observations were recorded in 605 patients (35.2%). Most discordant dermatological diagnoses included inflammatory disorders such as lichen planus, atopic dermatitis, bullous pemphigoid; mechanical disorders; nutritional deficiency disorders, and benign neoplasms.

Conclusion: Common skin conditions account for a large majority of dermatologic consultations in a hospital setting. Inpatient dermatology consultations improve the diagnostic accuracy.

Keywords: Concordance; hospital dermatology; inpatient dermatology consultation.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
(a) Bar chart showing concordance rates of dermatological consultations among different specialties. (b) Pie chart demonstrating various dermatological diagnoses in patients of all specialties
See this image and copyright information in PMC

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