Emergency department utilization of pediatric dermatology (PD) consultations

There are few published data about pediatric dermatology (PD) consultations in the pediatric emergency department (PED).

We profiled PD consultations to determine patterns of dermatology utilization by the PED.

We reviewed electronic medical records of 347 PD consultations from the PED over a 36-month period from January 2011 to December 2013. We recorded patient age and gender; PED diagnosis; PD diagnosis; skin biopsy, if needed, with histopathology report; and outpatient PD follow-up.

Patient age ranged from 3 days to 18 years with the majority (54.8%) of consultations for patients aged 0 days to 5 years. The most common diagnostic categories were infections and inflammatory skin disorders. Atopic dermatitis was the most common individual diagnosis. In all, 48.1% of patients had PD outpatient clinic follow-up. The rate of diagnostic agreement between the pediatric emergency medicine and PD provider was 58%.

Use of electronic medical records, retrospective study design, and population based at a tertiary-care children's hospital represent potential limitations.

PD providers contribute to patient care in the PED. Dermatology education in the PED should include the more commonly encountered disorders identified in this study, including infectious diseases and atopic dermatitis.