Dermatological Problems in a Neurology Clinic

Abstract

Background: Little is known about the profile of dermatological problems in patients hospitalized in neurology wards or neurological intensive care units (NICUs). In this study, we aimed to provide the demographic and clinical characteristics of inpatients admitted to the neurology ward or the NICU.Methods: This study was designed as a retrospective observational study. Medical records of patients who consulted with dermatology while they were hospitalized in the neurology ward or the NICU of our hospital, from January 2016 to June 2022, were reviewed retrospectively. Demographic and clinical characteristics of the patients were recorded.Results: A total of 106 patients, including 86 patients in the ward and 20 patients in the NICU, were included in the study. Forty-nine patients (46.2%) were female and 57 (53.8%) were male. The mean age was 58.47±18.84 years. The frequency of dermatology consultations was 1% overall. The most common causes of hospitalization were ischemic stroke (n=47), demyelinating diseases of the central nervous system (n=10), and encephalitis (n=7). The most common dermatological problems in patients were infectious dermatoses (n=25), drug eruptions (n=18), and physical dermatoses (n=18). While drug eruptions were encountered as a common problem in the neurology ward, physical dermatoses were a common problem in the NICU. Conclusion:The frequency of dermatology consultations requested from neurology for inpatients was low, especially in the NICU. Drug eruptions in the neurology ward and physical dermatoses in the NICU are encountered as common problems. Neurologists should pay attention to accompanying dermatological problems as well as neurological diseases. Large-scale prospective studies are needed for dermatological problems in patients hospitalized in the neurology clinic.

Post-intensive care syndrome (PICS) – complications after ICU stay: selected issues

“…Created in Canva, according to Canva's Content License Agreement. Available from: https://www.canva.com/policies/contentlicense-agreement/ ders of the genitourinary and gastrointestinal systems and skin [10,13,[25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] (Table 1).…”

“…Presence of an endotracheal tube and prolonged intubation -paralysis, paresis, vocal cord atrophy, laryngeal oedema, dysphagia, arytenoid cartilage injuries, upper airway obstruction [25,26] Presence of a tracheostomy tube -paralysis, paresis, vocal cord atrophy, laryngeal oedema, dysphagia, arytenoid cartilage injuries, upper airway obstruction [25,26], tracheal stenosis [25] -stoma opening infection, wound breakdown and granulation, uncoordinated glottal closure and mechanical airflow, vocal cord tremor, dysphonia [26] -glottic and laryngeal stenosis, tracheomalacia, recurrent infections [25] Other -exertional dyspnoea, impaired respiratory function [25] Cardiovascular system Arterial line -limb ischaemia due to embolism, less commonly pseudoaneurysms -scarring, numbness, neuropathic pain, and local tenderness of the limb [34] Venous catheter (CVC) -vasoconstriction and/or thrombosis, limb swelling, difficulty in further cannulation [30] Related to vasoactive treatment -arrhythmias, myocardial ischemia, metabolic disorders (e.g. hyperglycaemia), ischemia of distal body parts (most often fingers and toes), leading to necrosis and the need for amputation of parts or entire fingers/limbs [35,36] Post-critical illness cardiovascular disease (PICD) -hyperlipidaemia, hypertension, diabetes, coronary artery disease, cerebrovascular disease, heart failure, chronic kidney disease [27,28,38,39] Other -tissue remodeling in the parenchymal vascular bed, heart, kidney, vascular dysfunction, heart, atherosclerosis [27] Gastrointestinal system -difficulty in food intake and weight loss [39] -intestinal obstruction and malabsorption syndrome, change in taste, nausea, food aversion, anorexia [25] Genitourinary system -acute renal failure and risk of developing chronic renal failure and death [31,40] -tissue remodeling in the parenchymal vascular beds of kidney [29] -sexual dysfunctions [41] Musculoskeletal system -contractures, most commonly in elbows, ankles, knees, and hips; limitations in movement and activity [25] -risk of higher mortality, cause of irreversible disability [42] Skin -reduced skin perfusion [32,43] -limited hydration and maceration cause of susceptibility to damage [32,…”