Which Dermatological Conditions Present to an Emergency Department in Australia?

Abstract

Background/Objectives. There is minimal data available on the types of dermatological conditions which present to tertiary emergency departments (ED). We analysed demographic and clinical features of dermatological presentations to an Australian adult ED. Methods. The St. Vincent's Hospital Melbourne (SVHM) ED database was searched for dermatological presentations between 1 January 2009 and 31 December 2011 by keywords and ICD-10 diagnosis codes. The lists were merged, and the ICD-10 codes were grouped into 55 categories for analysis. Demographic and clinical data for these presentations were then analysed. Results. 123 345 people presented to SVHM ED during the 3-year period. 4817 (3.9%) presented for a primarily dermatological complaint. The most common conditions by ICD-10 diagnosis code were cellulitis (n = 1741, 36.1%), allergy with skin involvement (n = 939, 19.5%), boils/furuncles/pilonidal sinuses (n = 526, 11.1%), eczema/dermatitis (n = 274, 5.7%), and varicella zoster infection (n = 161, 3.3%). Conclusion. The burden of dermatological disease presenting to ED is small but not insignificant. This information may assist in designing dermatological curricula for hospital clinicians and specialty training organisations as well as informing the allocation of dermatological resources to ED.

Cellulitis of the Knee in a 16-Month-Old Boy: A Case Report

“…Clindamycin is considered the most effective agent against group A streptococci and is frequently used in the treatment of severe infections such as NF to prevent streptococcal toxic shock syndrome. [7][8][9][10][15][16][17][18][19][20][21][26][27][28][29] Methicillin-resistant S aureus has been talked about since the mid-20th century, when it was first discovered in humans. In the United States, about 3.2% of all ED visits between 2007 and 2010 were related to skin infection, and 68% were treated with anti-MRSA agent antibiotics.…”

“…In the United States, about 3.2% of all ED visits between 2007 and 2010 were related to skin infection, and 68% were treated with anti-MRSA agent antibiotics. 7,9,10,19,[23][24][25]27,28,30 About 10% of cellulitis cases are reported to be related to invasive MRSA 4. Because of the increased number of abscesses that turn into NF, cellulitis, and/or MRSA, hospitals are currently taking a more aggressive approach in treatment.…”

“…They all have similar initial presentation, and their outcome could vary from antibiotic treatment, surgical debridement, toxic shock, or death. 9,10,[15][16][17][18] Taking into consideration the fast progression of the erythematous reaction, irregular margins, striations, and nonpurulent presentation, the patient was diagnosed with acute cellulitis. The importance of immediate care was explained to the parents, and the patient was referred to the local emergency department (ED).…”

“…Other common presentations are seen among patients with a body mass index higher than 31, geriatric patients, and patients with a history of diabetes or immune compromise. 6,[9][10][11][12][13][14] The presentation of cellulitis to a chiropractic clinic is not commonly reported in the literature. At present, only 1 case report exists which describes the www.journalchiromed.com presentation in an adolescent.…”

Teledermatologists' management of emergency skin conditions

“…Such teledermatology services also provide valuable teaching opportunities for rural doctors and registrars. While there are numerous benefits, including improved timely access to specialist advice for rural patients and clinicians, and reduced unnecessary investigations and outpatient referrals, 1 the issues related to patient privacy and confidentiality must be addressed.…”