Patterns of inpatient dermatology referral and predictors of diagnostic accuracy in non‐dermatologists in a <scp>N</scp>orthern <scp>D</scp>istrict hospital in <scp>S</scp>ingapore

Huang, Wenhui; Chong, Wei‐Sheng

doi:10.1111/ijd.12815

Cited by 12 publications

(27 citation statements)

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“…Generally, skin lesions are identified and treated by non‐dermatologists, mainly internists, who often have some difficulty in interpreting these dermatological conditions, tending to establish inaccurate diagnoses and consequently inappropriate therapeutic management 1,2 . In hospitals, dermatology assistance usually occurs through consultations requested by other medical specialties, in which dermatologists are responsible for establishing the definitive diagnoses of skin diseases and its clinical management 4 …”

Section: Icd‐10/ Regions North Northeast Southeast South Central‐westmentioning

confidence: 99%

“…Skin diseases represent an important cause of morbidity and mortality among hospitalized patients, being the primary causes of hospitalization, or even developing during hospitalization due to clinical management 1 . Hospital skin disorders encompass a heterogeneous group of conditions with variable severity, such as urticaria, angioedema, viral and bacterial infections, autoimmune diseases, and severe drug eruptions, for instance Stevens–Johnson syndrome and toxic epidermal necrolysis 2 …”

Section: Icd‐10/ Regions North Northeast Southeast South Central‐westmentioning

confidence: 99%

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Hospital dermatology: an emerging subspecialty and its contributions to medical care

Ferreira

2020

Int J Dermatology

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cells expressed cytokeratins with diffuse and strong positivity for prostate-specific membrane antigen (PSMA) and PSAP labeling most tumor cells (Fig. 2d,e). PSA (Fig. 2c) and PAX8 expression (not shown) were absent. An expanded immunohistochemical workup showed that the tumor cells were positive for NKX3.1 (Fig. 2f). Overall, in the context of the morphology, immunohistochemical profile, and clinical history, a diagnosis of metastatic carcinoma of prostate origin was rendered. Despite its widespread utilization in surgical pathology to diagnose primary prostate cancer and metastasis to noncutaneous sites, there is only one prior report of NKX3.1 immunostaining being used to diagnose metastatic cutaneous prostate cancer. 5 Prior cases of cutaneous metastatic prostate cancer have been largely diagnosed and confirmed using PSA or PSAP, 3,4 which are cytoplasmic markers that may produce staining that is difficult to interpret. In contrast, NKX3.1 is a nuclear stain that is easy to interpret. This case demonstrates that NKX3.1-positive prostatic metastases are not an isolated finding and that NKX3.1 immunostaining may be useful in the diagnosis of cutaneous prostate cancer metastases.

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Section: Icd‐10/ Regions North Northeast Southeast South Central‐westmentioning

confidence: 99%

Section: Icd‐10/ Regions North Northeast Southeast South Central‐westmentioning

confidence: 99%

Hospital dermatology: an emerging subspecialty and its contributions to medical care

Ferreira

2020

Int J Dermatology

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“…Se observó un predominio del sexo masculino (57,3 %) frente al femenino (42,7%). Esta distribución se vio reflejada en la mayoría de trabajos previamente publicados, en los que el sexo masculino osciló entre el 51 % y el 60 % [36], [51], [52], [54]- [56], [58], [63], [65]- [68], [73], [79]- [81], conformando un menor número aquellos en los que predominó el sexo femenino [35], [59], [62], [70], [71]. Además, el predominio del sexo masculino se dio en todos los intervalos de edad (< 14, 15-64 y > 65 años).…”

Section: Datos Demográficosunclassified

“…enfermedades sistémicas están asociadas con manifestaciones cutáneas que pueden servir como pistas importantes para el diagnóstico de las afecciones médicas subyacentes. Estos datos coinciden con la mayoría de los trabajos publicados [35], [44], [46], [47], [50]- [54], [58], [62], [65], [66], [68], [70]- [73], [75]- [77], [79], [80].…”

Section: Distribución De Las Interconsultasunclassified

“…En el estudio español realizado por Lorente-Lavirgen et al [35] El procedimiento diagnóstico más utilizado fue la biopsia cutánea (53,4 %), seguida del cultivo (19,9 %), técnicas sencillas de realizar que aportan una relevante información. Estas dos pruebas también aparecen como las más frecuentemente solicitadas en la mayoría de los estudios publicados [35], [44], [46], [49], [58], [66].…”

Section: Estado Inmunológicounclassified

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Estudio epidemiológico de las interconsultas hospitalarias solicitadas al Servicio de Dermatología en el Complejo Asistencial Universitario de León = Epidemiological study of the hospital inter-specialty referrals requested to the Dermatology Service of the Healthcare University Complex in León

García¹,

Camino²

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Conclusiones La afección dermatológica en pacientes hospitalizados es muy prevalente y se debe, principalmente, a enfermedades comunes, no graves y de fácil manejo. La actividad consultora conlleva un importante impacto en el manejo de los pacientes ingresados con afectación cutánea al originar un cambio en el diagnóstico y tratamiento en un elevado porcentaje de casos, implica una mejora en la calidad asistencial, supone una reducción del coste sanitario, comporta una importante actividad formativa para los médicos residentes y proporciona una relación directa con otras especialidades conformando un elevado valor educativo para los facultativos no dermatólogos.

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Analysing referral patterns from a primary dermatological clinic to other medical institutions for further care: A survey on patients with certain skin diseases in Japan

Ueo,

Sakai,

Ochiai

et al. 2024

JEADV Clinical Practice

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BackgroundVarious skin diseases exist; some require specialist treatment. Consequently, patients with these conditions are often referred from primary dermatological clinics to other medical institutions for further secondary or tertiary care. However, it has yet to be fully evaluated at primary dermatological clinics which skin conditions necessitate such referrals.ObjectivesThis study aims to identify skin conditions that often require further care when treated at a primary dermatological clinic.MethodsThis study enroled 14,306 patients who had visited the Ueo Dermatology Clinic (a primary dermatological clinic in Saiki City, Oita prefecture, Japan) from 1 January 2020 to 31 December 2022. The following clinical information was examined: the primary disease, age, sex, whether referrals (general or emergency) were made after the clinic visit or not, and the reasons for the referrals.Results'Eczema and dermatitis' was the most frequent category in the clinic, although the referral rates for this category were not exceptionally high compared to other categories. A large number of emergency referrals was observed for 'Viral infections (herpes zoster),' 'Drug‐induced skin reactions,' and 'Bacterial infections (cellulitis)'; a large number of general referrals was observed for 'Malignant skin tumours and melanomas' and 'Benign skin tumours.' Although low numbers, the rates for general and emergency referrals were high in the categories of 'Blistering Diseases,' 'Connective Tissue Diseases,' and 'Vasculitis, Purpura, and Other Vascular Diseases.' In an analysis of the reasons for the referrals, the following reasons ranked highest: requirement for high‐level medical treatment, surgical operation, or hospitalisation, and consultation with doctors in departments other than dermatology.ConclusionsThis study identified several skin conditions often requiring additional care when treated at a primary dermatological clinic. Based on these findings, seamless cooperation between primary clinics and specialised medical institutions is anticipated.

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Patterns of inpatient dermatology referral and predictors of diagnostic accuracy in non‐dermatologists in a Northern District hospital in Singapore

Abstract: The need for a dedicated inpatient dermatology service is reinforced. However, targeted education may be employed to facilitate the referral process.

Cited by 12 publications

References 12 publications

Hospital dermatology: an emerging subspecialty and its contributions to medical care

Hospital dermatology: an emerging subspecialty and its contributions to medical care

Estudio epidemiológico de las interconsultas hospitalarias solicitadas al Servicio de Dermatología en el Complejo Asistencial Universitario de León = Epidemiological study of the hospital inter-specialty referrals requested to the Dermatology Service of the Healthcare University Complex in León

Analysing referral patterns from a primary dermatological clinic to other medical institutions for further care: A survey on patients with certain skin diseases in Japan

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