Emergency Consultations in Dermatology in a Secondary Referral Hospital in Southern Switzerland: A Prospective Cross-Sectional Analysis

Abstract

Background/Aims: The spectrum of dermatological emergencies is broad. Only a few studies have assessed the profile of dermatological conditions resulting in an emergency visit in a referral hospital. We sought to assess the conditions prompting an urgent dermatological visit and to compare the diagnoses with those made during the regular scheduled encounters. Methods: We performed a cross-sectional study of all patients with a cutaneous problem attending our emergency consultation during a 7-month period. The study variables were gender, age, duration of symptoms, diagnosis, need for hospitalization and/or follow-up. We further evaluated patients attending scheduled visits to compare the demographic characteristics and diagnoses between the two groups. Results: Six hundred fifty-two consecutive patients with an urgent dermatological consultation were included. Three hundred sixty (55.2%) were women and 292 (44.8%) were men. Infectious diseases (32.8%) as well as various forms of eczema (24.8%) constituted the most frequent causes for an emergency visit. Approximately 40% of emergency visits took place more than 1 week after the development of the cutaneous manifestations. The most frequent disorders seen in the 1,738 control patients included benign melanocytic and nonmelanocytic tumors (27.2%) and malignant skin lesions (11.5%). Conclusions: Our study indicates that the dermatological diagnoses in the emergency visits significantly differ from those of the routinely scheduled appointments. In a significant portion of patients, the use of an emergency consultation was not justified. This study provides support to the idea that a specific training is required to manage dermatological emergencies and that efforts should be made to reduce unjustified emergency visit use.

The effect of the COVID‐19 pandemic on dermatology consultation requests from adult and paediatric emergency departments

“…Furthermore, the hospitalisation rate among ED patients in the present study that were consulted to the dermatology department was 11.3% in 2019 and 6.6% in 2020. There were not any significant differences between the pre‐pandemic period and pandemic period regarding the frequency of non‐urgent and emergent ED presentations requiring hospitalisation, which is consistent with earlier pre‐pandemic research 5,24,25 . ED presentations because of non‐urgent dermatological complaints still constituted the majority of ED presentations in the present study, even during the pandemic period.…”

Emergency accesses in Dermatology Department during the Covid‐19 pandemic in a referral third level center in the north of Italy

“…In 2019, the most common skin diseases were eczematous disorders (n = 27, 16.5%), infectious diseases (n = 25, 15.2%), and physical and chemical injuries to the skin (n = 22, 13.4%), confirming the findings from similar studies in the past 9,10 . In 2020, all these categories were less frequent.…”

“…In 2019, the most common skin diseases were eczematous disorders (n = 27, 16.5%), infectious diseases (n = 25, 15.2%), and physical and chemical injuries to the skin (n = 22, 13.4%), confirming the findings from similar studies in the past. 9,10 In 2020, all these categories were less frequent. A few diagnostic categories showed significant difference in terms of incidence: scabies (3% vs 12.1%, P = .023), urticarial rashes (8.5% vs 21.2%, P = .03), and vasculopathic lesions (0.6% vs 12.1%, P < .0001).…”

Emergency room in a University Clinic of Dermatology and Venereology: Retrospective study of 2‐year experience

“…Table 1 shows the gender, age and diagnoses of examined patients. Similar distribution of diagnoses was reported in previous studies, [3][4][5][6][7] with the noteworthy exception in the group of acne and acneiform disorders, which presented quite frequently to our ER (3.3%). Additionally, of 2453 patients, 33 (1.4%) required hospital admission, which is lower than in other studies, where rates were ranged from 2.1% to 7.7%.…”