Dermatological emergencies: one-year data analysis of 8,620 patients from the largest Portuguese tertiary teaching hospital

Eur J Dermatol. 2016 Oct 1;26(5):460-464. doi: 10.1684/ejd.2016.2825.

Abstract

Skin conditions frequently lead to emergency department (ED) visits. While most are benign in course, some will present as true dermatological urgencies/emergencies, requiring admission. To present data on skin diseases most frequently found in the ED, and those most frequently requiring admission at the largest Portuguese tertiary teaching hospital, and to explore an association between epidemiological variables and frequency of diagnoses within this context. A retrospective study was conducted on all patients examined during 2012 for dermatology emergency consultation (DEC) at the Hospital de Santa Maria, Lisbon, Portugal. Association between epidemiological variables (gender and age of patients, and season of the year) and frequency of diagnoses was investigated. In total, 8,620 patients were examined by a dermatologist in the ED, constituting 3.9% of all ED visits in our centre. Overall, 333 diagnoses were made, the most frequent of which was eczema not-otherwise-specified (9.4%). However, infectious and parasitic diseases constituted the leading motive for DEC (31.5%). Only 264 patients were admitted, with 65 diagnoses leading to admission. Nine diagnoses alone led to 60% of all admissions. Infectious and parasitic diseases constituted the leading cause of admission (34.7%). An association between frequency of diagnoses and gender, age, and season was identified. Despite the variety of dermatological pathologies, only a limited group of diseases was responsible for most of the true dermatological emergencies. Therefore, in the absence of a readily available dermatologist, knowledge of these entities, as well as demographic and environmental data, may help to improve the management of these patients.

Keywords: dermatological emergency; emergency department; epidemiology; skin disease.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Emergency Service, Hospital*
  • Female
  • Hospitalization / statistics & numerical data
  • Hospitals, Teaching*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Portugal / epidemiology
  • Referral and Consultation / statistics & numerical data
  • Retrospective Studies
  • Seasons
  • Sex Factors
  • Skin Diseases / diagnosis
  • Skin Diseases / epidemiology*
  • Skin Diseases, Eczematous / diagnosis
  • Skin Diseases, Eczematous / epidemiology
  • Skin Diseases, Infectious / diagnosis
  • Skin Diseases, Infectious / epidemiology
  • Skin Diseases, Parasitic / diagnosis
  • Skin Diseases, Parasitic / epidemiology
  • Tertiary Care Centers
  • Young Adult