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Published on: September 26, 2019
Paediatric skin disorders encountered in an emergency hospital facility: a prospective study
Stéphane Auvin1, Astrid Imiela, Benoit Catteau
1Paediatric Emergency Care Unit, University Children's Hospital and School of Medicine, Lille, France. s-auvin@chru-lille.fr
Insights
Pediatric skin disorders are common in emergency care, with viral exanthema and atopic dermatitis being frequent. Dermatologist consultations improved diagnosis and treatment for children with skin conditions.
Area of Science:
- Dermatology
- Pediatrics
- Emergency Medicine
Background:
- Skin disorders are a common reason for pediatric emergency care visits.
- Accurate diagnosis and appropriate treatment are crucial for pediatric skin conditions.
Purpose of the Study:
- To determine the frequency of pediatric skin disorders in an emergency setting.
- To evaluate the impact of dermatologist consultation on diagnosis and treatment.
- To assess diagnostic agreement between pediatricians and dermatologists.
Main Methods:
- Prospective data collection of children with skin disorders over 5 months.
- Separate evaluations by pediatricians and dermatologists to assess diagnostic agreement.
- Analysis of diagnosis and treatment modifications following dermatologist consultation.
Main Results:
- Skin disorders accounted for 4% of pediatric emergency visits.
- Six common conditions included viral exanthema, urticaria, atopic dermatitis, varicella, diaper dermatitis, and herpetic gingivostomatitis.
- Dermatologists altered diagnoses in 42% and treatments in 30% of cases.
Conclusions:
- Improved training in pediatric dermatology for emergency care providers is needed.
- Enhanced access to dermatologists can improve the quality of care for pediatric skin conditions.
- Dermatologist input significantly impacts diagnostic and therapeutic decisions in pediatric emergency settings.
Abstract:
To determine the frequency of skin disorders encountered in a paediatric emergency care unit and to evaluate the benefits of advice from a dermatologist, we prospectively recorded data of children admitted with skin disorders to the emergency care unit during a 5-month period. Diagnostic agreement between paediatricians and dermatologists evaluating the patients separately was assessed. Three hundred and ninety-five children (median age 3 years; interquartile 1-6) were included. Skin disorders represented 4% of all paediatric emergency care unit visits. Visits were considered as appropriate in 19-30% of cases according to different criteria. Six diseases accounted for 57% of cases: viral exanthema, urticaria, atopic dermatitis, varicella, diaper dermatitis and herpetic gingivostomatitis. The dermatologist modified the diagnosis in 42% of cases and the treatment in 30%. Greater emphasis on teaching the skin disorders encountered in this setting and efforts to provide easy access to advice from dermatologist would improve the quality of care.
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