Paediatric dermatology emergencies in a tertiary hospital

Abstract

Abstract Introduction In recent years, the increasing demand for dermatological consultations in the Emergency Department has resulted in the publication of a variety of studies on this subject. However, most of them deal with the general population, without taking into account the changes in frequencies found in young children (ages 0–14). Objectives To determine the frequency of various dermatological diagnoses made by the on-call paediatrician in the Emergency Department, and after referral to paediatric dermatology. Materials and methods Firstly, a descriptive retrospective study was performed that included all patients aged between 0 and 14 years old who were seen after being referred to the emergency paediatric dermatologist by the on-call paediatrician from June 2010 to December 2013. Secondly, an analytical study was carried out by calculating the kappa index calculus, in order to establish the diagnostic concordance between the emergency paediatrician and the paediatric dermatologist. Results A total of 861 patients, with a mean age of 4.5 years were included. More than half of the skin disorders analysed were eczema (27%) and infections (26%). The five main diagnoses were: atopic dermatitis (16%), acute prurigo simplex (5%), tinea (5%), pyogenic granuloma (4%), and molluscum contagiosum (4%). Additional tests were only required in 16% of the cases. The kappa index obtained was 0.206 (95% CI : 0.170–0.241). Conclusions The dermatology consultations in the Emergency Department were shown to be frequent and mostly involved minor diseases. Collaboration between paediatricians and dermatologists resulted in a high treatment success rate, leading to a low percentage of additional tests required and a high rate of discharges.