An observational study to describe the clinical pattern of dermatological emergencies from emergency department and intensive care unit: Our experience from a tertiary care hospital in Northern India

Mitra, Debdeep; Chopra, Ajay; Saraswat, Neerja; Agarwal, Reetu; Kumar, Sushil

doi:10.4103/idoj.idoj_318_18

Cited by 7 publications

(7 citation statements)

References 10 publications

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“…Patients presenting to the ED with a dermatologic complaint are admitted in 2.2-26.9% of cases. [2][3][4][26][27][28][29][30] For patients receiving dermatology consultation, 18-49% are admitted to the hospital, which is consistent with the 27.6% admission rate in our study. 6,21,22,25 Jack et al 6 found that severe cutaneous adverse reactions (33%) and pemphigus vulgaris (14%) were the most common diagnoses in admitted patients.…”

Section: Diagnoses and Acuitysupporting

confidence: 86%

Retrospective analysis of 450 emergency department dermatology consultations: An analysis of in-person and teledermatology consultations from 2015 to 2019

et al. 2021

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Introduction Dermatologic complaints are a common reason for emergency department visits. Methods Retrospective chart review from 1 January 2015 to 31 December 2019. Patients in the Mayo Clinic Emergency Department receiving dermatology consultation were included. Results Dermatitis (24.7%, n = 113), infection (20.4%, n = 93), and drug reaction (10.3%, n = 47) accounted for the majority of diagnoses. Emergency department providers often provide no diagnosis (38%) or a differential diagnosis (22%), and dermatology consultation frequently alters diagnosis (46%) and treatment (83%). Patients receiving in-person consultations are admitted more frequently than those receiving teledermatology consultations (40% vs. 16%, p < 0.001). Primary diagnostic concordance with subsequent dermatology evaluation is high for in-person (94%) and teledermatology (88%) consultations. Discussion This is the largest study of emergency department dermatology consultations in the United States and the first to compare in-person and teledermatology emergency department consultation utilization in clinical practice. These modalities are utilized in a complementary fashion at our institution, with severe dermatologic diagnoses seen in-person. The valuable role of emergency department dermatologists is highlighted by frequent changes to diagnosis and treatment plans that result from dermatology consultation. Furthermore, our data suggest that teledermatology is an effective modality with the potential to expand access to dermatologic expertise in the emergency department setting.

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Section: Diagnoses and Acuitysupporting

confidence: 86%

Retrospective analysis of 450 emergency department dermatology consultations: An analysis of in-person and teledermatology consultations from 2015 to 2019

et al. 2021

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“…Included in the final review, following screening and eligibility, were 180 records (Figure 1). 1–58,60–63,67–187 The use of the term “skin failure” has increased over time, reaching 12 publications in 2009 and steadily increasing to a peak of 19 records in 2019 (Figure 2).…”

Section: Resultsmentioning

confidence: 99%

“…In dermatology, “skin failure” is a term that has been used since 1990 to describe severe skin conditions such as erythroderma, burns, pemphigus, Stevens-Johnson syndrome, and toxic epidermal necrolysis 3–58 . These conditions occur suddenly and result in the derangement of normal skin function, including loss of temperature control, percutaneous fluid, proteins and electrolytes, and mechanical barrier function.…”

Section: Introductionmentioning

confidence: 99%

Understanding Skin Failure: A Scoping Review

Dalgleish

Campbell

Finlayson

et al. 2021

Adv Skin Wound Care

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OBJECTIVE To map the use of the term “skin failure” in the literature over time and enhance understanding of this term as it is used in clinical practice. DATA SOURCES The databases searched for published literature included PubMed, Embase, the Cumulative Index for Nursing and Allied Health Literature, and Google Scholar. The search for unpublished literature encompassed two databases, Open Gray and ProQuest Dissertation and Theses. STUDY SELECTION Search terms included “skin failure,” “acute skin failure,” “chronic skin failure,” and “end stage skin.” All qualitative and quantitative research designs, editorial, opinion pieces, and case studies were included, as well as relevant gray literature. DATA EXTRACTION Data collected included author, title, year of publication, journal name, whether the term “skin failure” was mentioned in the publication and/or in conjunction with other skin injury, study design, study setting, study population, sample size, main focus of the publication, what causes skin failure, skin failure definition, primary study aim, and primary outcome. DATA SYNTHESIS Two main themes of skin failure were identified through this scoping review: the etiology of skin failure and the interchangeable use of definitions. CONCLUSIONS Use of the term “skin failure” has increased significantly over the past 30 years. However, there remains a significant lack of empirical evidence related to skin failure across all healthcare settings. The lack of quality research has resulted in multiple lines of thinking on the cause of skin failure, as well as divergent definitions of the concept. These results illustrate substantial gaps in the current literature and an urgent need to develop a globally agreed-upon definition of skin failure, as well as a better understanding of skin failure etiology.

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“…1 Few reports have described the skin findings of patients admitted to intensive care units (ICUs). [2][3][4][5] Dermatologic diseases represent approximately 0.5% of the motives of admission into critical care settings, but the reported prevalence of cutaneous conditions within this context varies from 2.2% to 14%. [3][4][5] Mortality associated with acute skin failure (ASF) rises to 35%.…”

Section: Introductionmentioning

confidence: 99%

“…However, the associated cutaneous hypoperfusion, immobility and polypharmacy predispose to dermatologic complications 1 . Few reports have described the skin findings of patients admitted to intensive care units (ICUs) 2–5 . Dermatologic diseases represent approximately 0.5% of the motives of admission into critical care settings, but the reported prevalence of cutaneous conditions within this context varies from 2.2% to 14% 3–5 .…”

Section: Introductionmentioning

confidence: 99%

Dermatological manifestations in the intensive care unit of a third‐level hospital

Méndez‐Flores,

Mireles‐Alvarez,

Barrera‐Godinez

et al. 2024

JEADV Clinical Practice

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BackgroundDermatologic diseases are common in patients being treated in intensive care units (ICU). However, due to the seriousness of the patient's condition, skin diseases take a backseat, although these are sometimes the cause of the greatest deterioration. Very few studies focusing on these dermatoses have been undertaken.ObjectivesThis study aimed to determine the prevalence and spectrum of dermatological disorders in patients treated in a medical ICU of a tertiary care centre.MethodsThis was a descriptive study conducted over a period of 8 months. All the patients admitted to the medical ICU were examined for the presence of any pre‐existing or newly developed dermatological disorder. Dermatological disorders were initially classified into infective and noninfective. Patients with dermatological findings were classified into two groups: those who survived and those who died; they were compared with each other with respect to age and sex distribution, length of ICU stay and dermatological findings.ResultsOut of 776 cases admitted to the ICU during the study period, dermatological disorders were observed in 164 (21.13%) cases. Life‐threatening dermatological disorders were seen in 3.05% of cases. Twenty‐nine (17.68%) patients with dermatological findings died. Among these cases, infectious dermatological disorders were significantly less common, while no significant difference was observed for reactive dermatological disorders.ConclusionsDermatological disorders in ICU are common and have a wide spectrum. They often need treatment and may be indicative of underlying potentially fatal systemic illness. Besides, a subset of cutaneous lesions may develop in response to various medical interventions, immunosuppression and immobility. Knowledge of such dermatoses is thus essential, both for the intensivist and dermatologist.

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An observational study to describe the clinical pattern of dermatological emergencies from emergency department and intensive care unit: Our experience from a tertiary care hospital in Northern India

Cited by 7 publications

References 10 publications

Retrospective analysis of 450 emergency department dermatology consultations: An analysis of in-person and teledermatology consultations from 2015 to 2019

Retrospective analysis of 450 emergency department dermatology consultations: An analysis of in-person and teledermatology consultations from 2015 to 2019

Understanding Skin Failure: A Scoping Review

Dermatological manifestations in the intensive care unit of a third‐level hospital

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