Skin lesions in the ICU

Area of Science:

• Critical Care Medicine
• Dermatology
• Epidemiology

Background:

• Skin lesions are frequently observed in intensive care unit (ICU) patients.
• The specific dermatological disorders (DDs) and their clinical impact in the ICU setting require further elucidation.

Purpose of the Study:

• To identify the most common dermatological disorders (DDs) in ICU patients.
• To determine the incidence of these DDs.
• To assess the impact of DDs on patient mortality, disease severity, and length of ICU stay.

Main Methods:

• A 2-year prospective study was conducted in a general medical and surgical ICU.
• All patients presenting with skin lesions on admission or during their ICU stay were included, encompassing pediatric cases.
• Data collected included demographic information, diagnosis of DDs, severity scores (SAPS II), and patient outcomes.

Main Results:

• Forty-six patients (10% of total admissions) were enrolled, with 51 diagnosed DDs.
• Patients with DDs had significantly higher SAPS II scores (43) and a longer mean ICU stay (19 days) compared to the general ICU population.
• Mortality rates between patients with and without DDs were not statistically significant (26% vs. 29%).

Conclusions:

• Dermatological disorders are a notable concern in critically ill patients, with a non-negligible incidence.
• Routine skin examination upon admission and throughout the ICU stay is crucial for timely diagnosis and management of DDs.
• While not directly increasing mortality, DDs are associated with increased disease severity and prolonged hospitalization in the ICU.