Dermatologists in Hospital Wards: An 8-Year Study of Dermatology Consultations

BACKGROUND: The value of dermatologists as consultants is increasing. OBJECTIVE: To evaluate the activity of dermatologists as inpatient consultants. METHODS: Retrospective study of consultations to Dermatology of inpatients, visits per consultation, referral service, procedures performed, delay until visit and diagnoses based on ICD-9. RESULTS: 3,144 requests generated 4,824 visits, 200 biopsies, 107 cultures and other procedures. The mean delay between request and visit was 0.75 days. The requesting service was recorded in 3,097 cases: 21.5% by Internal Medicine, 11.4% by Pediatrics, 8.3% by Neurology and 6.2% by the Infectious Diseases Unit. Follow-up was recommended in 12.4% by the Dermatology Service and in 8% by a dermatologist. Reliable diagnoses were recorded for 2,832 consultations. The most frequent diagnostic groups were diseases of the skin and subcutaneous tissue (ICD-9: 680-709) in 58%, infectious and parasitic diseases (ICD-9: 001-139) in 20%, and neoplasm (ICD-9: 140-239) in 5.7%. The most frequent diagnoses were contact dermatitis (ICD-9: 692.X) in 8.9%, drug reactions (ICD-9: 693.0) in 7.4%, candidiasis (ICD-9:112.X) in 7.1% and seborrheic dermatitis (ICD-9: 690) in 5.3%. CONCLUSIONS: Most diagnoses were of a specific cutaneous disease and the dermatologist would be in the best position to evaluate those that inpatients acquire.