Hospital Dermatology: analysis of dermatological consultations in a tertiary teaching hospital

Abstract

Background: In hospital settings, dermatology can offer substantial clinical support for the diagnosis and management of skin conditions, reducing morbidity and mortality. Thus, the study aimed to analyze the profile of referrals and consultations performed by the Dermatology Service of the Santa Casa de Misericordia de Porto Alegre, from August 2018 to January 2020.

Methods: This study is descriptive, quantitative, and retrospective, conducted through data collection and review of medical records and referrals. The variables included were clinical data of referrals, in-patients profiles, dermatological diagnoses, complementary exams, therapeutic conduct, and recommended follow-ups.

Results: A total of 1020 referrals were analyzed, which resulted in 641 consultations (328 men, 313 women). The most prevalent skin disease groups were 'Dermatitis and Eczema' (33.1%) and 'Other infectious skin diseases (21.8%), while the most frequent ICD-10 were 'Drug eruptions - L27' (9.9%) and 'Other and unspecified dermatitis - L30' (6.6%). Corticoids were the most recommended treatments (27.7%), followed by antifungals (13.1%). 'Consultation Discharge' (44%) and 'Outpatient' Dermatology follow-up (27%) were the most frequent causes for ending consultation.

Study limitations: Among the study limitations, the authors highlight its retrospective nature, with data analysis based on referrals and medical records, which may present inaccurate or incomplete information. In addition to this, the study may demonstrate a certain degree of subjectivity due to the review and interpretation process conducted by the researchers. However, the definition of objective criteria based on previous studies attenuates such possible bias. Furthermore, considering that the Dermatology teams are composed of a preceptor dermatologist and residents, the established diagnoses were not submitted to third-party verification, except in the cases of skin biopsies and cultures. Thus, the professional's experience and skills may have influenced the dermatological diagnoses.

Conclusions: These findings underlie the importance of Dermatology in hospital assistance, contributing to the management of a wide range of skin conditions.

Keywords: Dermatology; Epidemiology; Health services research; Inpatients; Skin and connective tissue diseases; Skin diseases.

Figure 1

Flowchart of research methods * Referrals and consultations performed from August 2018 to January 2020.

Figure 2

Flow of hospital dermatological consultations referrals from August 2018 to January 2020

Figure 3

Referring medical areas of dermatological consultations

Figure 4

Skin diseases groups of dermatological consultations. by hospitals. from August 2018 to January 2020*. * Chi-Square Test (X² = 114.754). p < 0.001 ** Clinical Hospitals: Hospital Santa Clara (HSC). Hospital São Francisco (HSC). Pavilhão Pereira Filho (PPF). Hospital Dom Vicente Scherer (HDVS). Pediatric Hospital: Hospital da Criança Santo Antônio (HCSA). Oncology Hospital: Hospital Santa Rita (HSR).

Figure 5

Skin diseases groups of dermatological consultations. by referring medical specialties. from August 2018 to January 2020* * Chi-Square Test (X² = 147.882). p < 0.00).