Dermatology inpatient consultations in a tertiary hospital - a retrospective analysis

Dermatology consultation has been shown to have a significant beneficial impact on admitted hospital patients with concurrent or newly diagnosed skin conditions. This study aimed to determine the change in diagnosis and management after dermatology consultation in a tertiary Australian referral hospital.

A retrospective analysis of dermatology consultations for hospital inpatients from June 1, 2018, through November 11, 2019, was performed. Demographic and clinical data were extracted from electronic medical records, and a chi-squared test was used to analyze categorical variables.

There were 306 consultations during the period of interest. The male to female ratio was 1:1 with a median age of 63. Consultations were most often requested by medical teams (69%), and the majority of patients seen in the emergency department were discharged home (86%). In 44% of cases, the requesting team did not provide a diagnosis; in the cases where it did provide a diagnosis, it was changed 57.9% of the time. The most commonly misdiagnosed conditions were dermatitis and skin infections. Dermatologists established or changed management in 82% of cases, and a total of 676 suggestions were made for management.

The results of this review reinforce the value of dermatology input in the diagnosis and management of hospital in patients. Ensuring maintained presence of hospital-based dermatologists has the potential to improve diagnosis and management of cutaneous issues early on; by extension, this can minimize unnecessary investigations, improve the quality of healthcare, reduce hospital burden, and facilitate outpatient follow-up.