Dermatology-led lower-limb cellulitis service: analysis of 1579 referrals (2007-15)

Dermatology on-call should be commissioned and funded to support acute hospital services

“…The most frequent diagnosis in on‐call referrals was cutaneous drug reactions, followed by cellulitis (Table ). Other patients with cellulitis were seen urgently in the department via the innovative nurse‐led cellulitis service, and were not included in this analysis.…”

Lower limb cellulitis: low diagnostic accuracy and underdiagnosis of risk factors

“…This proforma was improved in January 2018 to include specific questions on cellulitis risk factors, rather than open questions. This is the world's largest reported series of 1746 consecutive patients referred from 2007 to July 2018 with possible LLC (as of 22 July 2018), with previous reported audits in 2010 and 2015 …”

“…Accurate diagnosis and identification of risk factors are essential for optimal patient care. Previous audits at NNUH identified inaccurate diagnosis and inadequate recognition of risk factors, so these were re‐audited in July 2018.…”

Cellulitis: how can we know what patients don't know?

“…If a hospital stay costs £2553 the NHS cost is £226 million/year. As up to 30% of cellulitis diagnoses may be inaccurate, some of this human and financial cost could be avoided through early review by dermatologists . However, dermatology services are not usually staffed to deal out‐of‐hours with inpatients with septic cellulitis, often with multiple comorbidities.…”

“…With shared care involving internal physicians and primary care, dermatologists can help with diagnosis and also with the management of people who are well enough to stay at home on daily intravenous antibiotics. Dermatologists can diagnose and manage predisposing skin diseases …”