Combined Pediatric Rheumatology/Dermatology Clinics: Benefits and Challenges

Area of Science:

• Pediatric Rheumatology
• Pediatric Dermatology
• Integrated Care Models

Background:

• Combined rheumatology/dermatology clinics (RDCs) offer efficient specialist coordination and comprehensive care.
• Limited literature exists on the logistics, outcomes, benefits, and challenges of pediatric RDCs.

Purpose of the Study:

• To characterize the patient cohort at a pediatric RDC.
• To survey pediatric dermatologists participating in RDCs regarding their experiences and perceptions.

Main Methods:

• Retrospective review of 71 new patients at UCSF Pediatric RDC (September 2017-September 2023).
• Survey distributed to 17 North American dermatologists representing unique pediatric RDCs in 2024.

Main Results:

• Female patients comprised 69%.
• RDC visits established or confirmed diagnoses in 41% of new cases and 96% of established cases.
• Common diagnoses included linear morphea (33%), lupus (23%), and psoriasis (13%).
• 23% received new systemic therapy; 8% had skin biopsies and 28% had imaging.
• All RDCs included trainees, but only 59% had administrative support.
• 100% found RDCs valuable for patient care; 88% found them a valuable use of time.

Conclusions:

• Pediatric RDCs facilitate consensus diagnosis, streamlined evaluation, and management of complex pediatric cases.
• RDCs provide educational opportunities and are valued by patients and clinicians, despite generally poor clinical and administrative support.