Recognition of dermatological conditions by junior doctors on general medical wards

Although we know something about the prevalence of various dermatological conditions in the community, virtually nothing is known about the prevalence and type of skin conditions affecting general medical patients in hospital. This has important implications for both undergraduate training and the continuing education of junior doctors about common skin disorders. In this study we examine the prevalence of skin conditions in 100 in-patients on four general medical wards, and assess the awareness and diagnostic accuracy of junior doctors encountering common dermatological conditions in their patients. Forty-six patients had one or more skin conditions, excluding seborrhoeic warts, skin tags, benign pigmented naevi and Campbell De Morgan spots. The 16 junior doctors correctly diagnosed 64% of common skin conditions that should have been covered in the undergraduate curriculum but detected only 43% of the two malignant skin lesions (basal cell carcinomas) identified in the study. The presence of skin conditions was rarely recorded in the notes, even when the condition was potentially relevant to the general medical condition of the patient. This study highlights the need for greater awareness of skin disease amongst junior doctors in order to avoid unnecessary patient morbidity.