Abstract
BackgroundSkin diseases are underestimated and overlooked by most clinicians despite being common in clinical practice. Many patients are hospitalized with co-existing dermatological conditions which may not be detected and managed by the attending physicians. The objective of this study was to determine the burden of co-existing and overlooked dermatological disorders among patients admitted to medical wards of Muhimbili National hospital in Dar es Salaam.Study design and settingsA hospital-based descriptive cross-sectional study conducted at Muhimbili National hospital in Dar es Salaam, Tanzania.MethodsPatients were consecutively recruited from the medical wards. Detailed interview to obtain clinico-demographic characteristics was followed by a complete physical examination. Dermatological diagnoses were made mainly clinically. Appropriate confirmatory laboratory investigations were performed where necessary. Data was analyzed using the 'Statistical Package for Social Sciences' (SPSS) program version 10.0. A p-value of < 0.5 was statistically significant.ResultsThree hundred and ninety patients admitted to medical wards were enrolled into the study of whom, 221(56.7%) were females. The mean age was 36.7 ± 17.9 (range 7-84 years). Overall, 232/390 patients (59.5%) had co-existing dermatological disorders with 49% (191/390) having one, 9% (36/390) two and 5 patients (1%) three. A wide range of co-existing skin diseases was encountered, the most diverse being non-infectious conditions which together accounted for 36.4% (142/390) while infectious dermatoses accounted for 31.5% (123/390). The leading infectious skin diseases were superficial fungal infections accounting for 18%. Pruritic papular eruption of HIV/AIDS (PPE) and seborrheic eczema were the most common non-infectious conditions, each accounting for 4.3%. Of the 232/390 patients with dermatological disorders, 191/232 (82.3%) and 154/232 (66.3%) had been overlooked by their referring and admitting doctors respectively.ConclusionDermatological disorders are common among patients admitted to medical wards and many are not detected by their referring or admitting physicians. Basic dermatological education should be emphasized to improve knowledge and awareness among clinicians.
Highlights
Skin diseases are underestimated and overlooked by most clinicians despite being common in clinical practice
Pruritic papular eruption of HIV/acquired immunodeficiency syndrome (AIDS) (PPE) and seborrheic eczema were the most common non-infectious conditions, each accounting for 4.3%
Dermatological disorders are common among patients admitted to medical wards and many are not detected by their referring or admitting physicians
Summary
Skin diseases are underestimated and overlooked by most clinicians despite being common in clinical practice. The objective of this study was to determine the burden of co-existing and overlooked dermatological disorders among patients admitted to medical wards of Muhimbili National hospital in Dar es Salaam. The prevalence of dermatological disorders among admitted patients reported by some of these studies shows an almost similar spectrum, differing only in magnitude between developing and developed countries [14]. Conditions such as Stevens Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), autoimmune blistering diseases, necrotizing fasciitis, leg ulcers, dermatological malignancies and psoriasis have been reported as the common indications for hospital admission in developing as well as the developed countries[14,15]
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