Dermatological Emergencies Research Articles

Pediatric dermatologic emergencies.

Provide an overview of recent findings and recommendations for the presentation, diagnosis, and management of pediatric dermatologic emergencies. Updated information on optimal diagnosis and treatments for pediatric dermatologic emergencies because of infection, reactive infectious mucocutaneous eruption, and serious cutaneous adverse reactions are covered. Pediatric dermatologic emergencies require prompt diagnosis and management. This review covers new agents and techniques for management and diagnosis.

Dermatological emergencies and determinants of hospitalization in Switzerland: A retrospective study.

Dermatologic conditions are estimated to account worldwide for approximately 8% of all visits at emergency departments (EDs). Although rarely life-threatening, several dermatologic emergencies may have a high morbidity. Little is known about ED consultations of patients with dermatological emergencies and their subsequent hospital disposal. We explore determinants and clinical variables affecting patients' disposal and hospitalization of people attending the ED at a Swiss University Hospital, over a 56-month observational period, for a dermatological problem. De-identified patients' information was extracted from the hospital electronic medical record system. Generalized estimating equations were used to explore determinants of patient's disposition. Out of 5096 consecutive patients with a dermatological main problem evaluated at the ED, 79% of patients were hospitalized after initial assessment. In multivariable analyses, factors which were significantly associated with an increased admission rate included length of ED stay, age ≥ 45 years, male sex, distinct vital signs, high body mass index, low oxygen saturation, admission time in the ED and number and type of dermatological diagnoses. Only 2.2% of the hospitalized patients were admitted to a dermatology ward, despite the fact that they had dermatological diagnoses critically determining the diagnostic related group (DRG) payment. The number of patients managed by dermatologists during in-patient treatment significantly decreased over the study period. Our study identifies a number of independent predictors affecting the risk of hospital admission for patients with dermatological conditions, which may be useful to improve patients' disposal in EDs. The results indicate that the dermatological specialty is becoming increasingly marginalized in the management of patients in the Swiss hospital setting. This trend may have significant implications for the delivery of adequate medical care, outcomes and cost-effectiveness. Dermatologists should be more engaged to better position their specialty and to effectively collaborate with nondermatologists to enhance patient care.

Stevens Johnson Syndrome Review

Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are dermatologic emergencies that are distinguished by extensive epidermal necrolysis and sloughing. The incidence rates are location-dependent. Mortality rates vary from 4.8-9% to 14.8-48%, with females being more frequently affected than males. Supportive care, infection control, wound care, and fluid and electrolyte management comprise nonpharmacologic treatment for SJS/TEN patients. The identification and cessation of the causative substance are the most critical components. The management of fluid, electrolytes, and nutrition is essential for SJS/TEN patients, as they have lower fluid requirements than burn patients. Prophylactic antibiotics do not improve outcomes; however, infection prevention necessitates appropriate wound care and antiseptic handling. The decision to pursue surgical debridement is contingent upon the location of care, and the function of this treatment option has been a subject of controversy. Anti-shear therapy, which entails the preservation of denuded epidermis and the aspiration of blister fluid, has been demonstrated to be effective in decreasing mortality rates. The disease's rarity has resulted in a scarcity of prospective studies on pharmacologic treatment for SJS/TEN. There have been reports of a variety of treatment regimens that involve corticosteroids, IVIg, cyclosporine, and TNF-alpha inhibitors. However, it is difficult to ascertain whether the disease's remission was caused by a specific treatment or the natural course of the disease. Studies have demonstrated that supportive care and cyclosporine have the potential to serve as alternative treatments for SJS/TEN. A meta-analysis of 10 studies revealed that patients who received cyclosporine had a survival advantage, while a meta-analysis of 67 studies revealed that the combination of corticosteroids and IVIg resulted in statistically significant improvements in outcomes. The severity of illness scores in patients with SJS/TEN overlap or TEN was reduced by plasmapheresis, which entails plasmapheresis and corticosteroids. In 86.8% of patients, TNF-alpha inhibitors have also demonstrated positive outcomes, despite their immunosuppressive properties. Nevertheless, the most effective pharmacological treatment for SJS/TEN must be determined by taking into account practical factors, such as cost. There is a lack of consensus regarding the most effective treatment, and additional research is required to ascertain the most effective treatment.

Stevens Johnson Syndrome and Toxic Epidermal Necrolysis Updates on Management

Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are dermatologic emergencies characterized by extensive epidermal necrolysis and sloughing. The incidence rates vary depending on location, with the UK experiencing an annual incidence of 5.76 cases per million individuals from 1995 to 2013. Females are more frequently afflicted than males, with mortality rates ranging from 4.8-9% to 14.8-48%. Nonpharmacologic treatment for SJS/TEN patients includes supportive care, fluid and electrolyte management, infection control, and wound care. The most critical component is the identification and cessation of the causative substance. Management of fluid, electrolytes, and nutrition is crucial for SJS/TEN patients, as they have lower fluid requirements than burn patients. Prophylactic antibiotics do not enhance outcomes, but infection prevention requires appropriate wound care and antiseptic handling. The role of surgical debridement has been a topic of controversy, and the decision to pursue this treatment option depends on the location of care. Anti-shear therapy, which involves aspiration of blister fluid and preservation of denuded epidermis, has been shown to be effective in reducing mortality rates. Pharmacologic treatment for SJS/TEN has been the subject of few prospective studies due to the disease's rarity. Various treatment regimens involving corticosteroids, IVIg, cyclosporine, and TNF-alpha inhibitors have been reported, but it is challenging to determine whether the disease's remission was due to a specific treatment or the natural course of the disease.

Identifying dermatological emergencies in patients with skin of colour: Insights from Australian emergency medicine practitioners.

Identifying dermatological emergencies in patients with skin of colour: Insights from Australian emergency medicine practitioners.

Empowering advanced clinical practitioners in managing acute dermatological emergencies.

Advanced clinical practitioners (ACPs) encounter patients with acute dermatological presentations ranging from minor to life-threatening conditions in both primary and secondary care settings. However, ACPs often feel unprepared to assess and treat patients with dermatological emergencies. This article aims to provide guidance to trainee and qualified ACPs, whether in acute hospital settings or primary care, in understanding the essential aspects to consider when consulting with patients presenting with acute dermatological emergencies. It also emphasises appropriate referrals to relevant specialties for necessary inpatient or outpatient investigations and ensure prompt treatment.

Pathogenesis and A Practical Guide to the Management of Steven-Johnson Syndrome & Toxic Epidermal Necrolysis

Steven Johnson Syndrome (SJS) and Toxic Epidermal necrolysis are rare dermatological emergencies that are associated with a high degree of morbidity and mortality [1]. They are considered to be severe blistering conditions that portray an image of diffuse epidermal necrolysis in association with sloughing of the skin. SJS and TEN are effectively the same disease with the main difference being the percentage of body surface area involved. It is widely accepted that SJS belongs to the below 10% body surface area category and TEN to the more than 30% category. A Steven Johnson syndrome and Toxic Epidermal Necrolysis overlap exists when the body surface area affected is between 10 percent and 30 percent [2]. The causes of both conditions within this spectrum are most likely drug related, however certain infections can also trigger SJS/TEN but this is less likely. In a substantial number of cases the cause is idiopathic [3]. The main grading system is the SCORTEN criteria, which can also provide more information regarding prognosis and mortality [4]. Management of this condition is highly controversial with no clear guidelines but there is a wide agreement that patients should be managed in a burns unit with intravenous fluids and protection from secondary infections. Stopping all medications and investigating for the cause is important unless there is clear benefit from any single medication.

Clinico- Therapeutic Study of Stevens Johnson Syndrome-Toxic Epidermal Necrolysis and Prognostic Significance of SCORTEN in Indian Patients.

Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are life-threatening dermatological emergencies. SCORTEN (SCORe of toxic epidermal necrolysis) is a validated score to predict mortality; however, there is a paucity of data to determine its usefulness in the Indian population. To evaluate the accuracy of SCORTEN as a prognostic marker in SJS-TEN. A prospective observational study was conducted at a tertiary care hospital for two years. SCORTEN was calculated on days one and three of admission. The actual death rates were compared to the predicted rates as estimated by the SCORTEN by standardised mortality ratio analysis (SMR). Of 40 cases included in the study, the mean age was 36.2 ± 14 years (range 11-65) with the male: female ratio being 1.67:1. Antibiotics (37.5%) were the most common group followed by anticonvulsants (22.5%). Comorbidities were observed in 60% of cases, with epilepsy (17.5%) and HIV (human immunodeficiency virus) infection (12.5%) being common. On univariate analysis, heart rate > 120/min, epidermal detachment > 10% BSA, and Se HCO3 (bicarbonate) <20 mmol/L were associated significantly with the death of the subjects (P < 0.05). The observed mortalities were 4.34%, 0, 0 and 80% for SCORTEN 0-1 (3.2%), 2 (12.1%), 3 (35.8%) and 4 (58.3%) respectively when compared to expected mortality. SMR of SJS was 0.69 and of TEN was 1.49. SCORTEN gave an overestimation of mortality in patients with lower scores and an underestimation of mortality in patients with higher scores in our study. Minor refinements based on the study population may increase the predictive accuracy of the original scale.

Compliance with Society Guidelines in COVID-19: A Survey on Members of Society of Dermatologists, Venereologists and Leprologists of Nepal

Introduction: COVID-19 pandemic affected the practice of dermatologists of Nepal. The Society laid down the guidelines for safe practice in the interest of its members and patients based on the available evidence at that time. The aim of this study was to assess the compliance of members to its guidelines. Methods: This was a descriptive cross-sectional study carried out from 1st June 2020 to 1st July 2020 by circulating questionnaire via Google form to dermatologists who were members of Society of Dermatologists, Venereologists, and Leprologists of Nepal. The mstudy variables included personal details of the participants and questionnaires related to guidelines. The responses of participants were collected, and descriptive analysis of the data was done. Results: Out of 200 members at the time of study who were sent the mail, only 90 (45%) members responded to the questionnaire. Out of all these respondents, 76 (84.4%) were following the guidelines laid down by the society. Only 43 (47.8 %) of the respondents had deferred patients of outpatient department as per the guidelines. Out of all respondents, 60 (66.7%) had attended dermatological emergencies and triage was done by 50 (55.6%) members. Conclusion: The study showed that most of the members who were responsive to the survey questions sent to them were compliant with the guidelines laid down by the society.

Toxic Epidermal Necrolysis Induced by Allopurinol, One Case in a Million

Background:Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are part of the spectrum of one of the most serious dermatological conditions that occur in the hospital setting, considered a dermatological emergency. Stevens-Johnson syndrome is called toxic epidermal necrolysis (TEN) when ≥30% of the body surface is affected, and it is the most serious form of the disease, with adverse drug reactions being the main etiology, up to 80%. Clinical case:We present the clinical case of a 30-year-old male, with a history of systemic arterial hypertension, who began with symptoms after taking allopurinol after being diagnosed with hyperuricemia. It began with a picture of bilateral conjunctivitis, followed by a sudden appearance of localized dermatosis on the face, characterized by erythematous plaques with indistinct, non-painful borders, and later the appearance of ulcers and blisters, extending to 70% of the body surface. During his hospitalization, he developed a lesion acute renal failure, managed by the intensive care service, with total remission upon discharge and favorable response to treatment thanks to multidisciplinary management. Treatment was provided with human immunoglobulin, vancomycin-based antibiotic therapy, and ciprofloxacin for impetiginization of facial ulcers, fluid therapy, Vaseline gauze dressings, and topical ophthalmological treatment, achieving discharge without comorbidities. Conclusion:Toxic epidermal necrolysis is a severe picture of Steven Johnson Syndrome, potentially fatal, which requires early multidisciplinary management that leads to the recognition and management of associated comorbidities in a timely manner.Key words: Stevens-Johnson syndrome; toxic epidermal necrolysis; halopurinol, drug reaction.

Dermatological Emergencies in Family Medicine: Recognition, Management, and Referral Considerations

Dermatological Emergencies in Family Medicine: Recognition, Management, and Referral Considerations

Case Report: Toxic epidermal necrolysis: a rare pediatric case report from Nepal

Toxic epidermal necrolysis (TEN) is a life-threatening cutaneous reaction to various medications like antibiotics and antiepileptics characterized by erythematous rashes, diffuse necrosis, and exfoliation of skin and mucous membranes, with a high mortality rate. Here, we present a case of six years old female child from Nepal who presented with fever and rashes, was diagnosed with measles and treated with cefixime, ibuprofen, and other drugs. Six hours after taking the drugs, the child developed generalized rashes, blisters formation, and peeling of the skin which progressed to cover most of the skin of her body within the next two days. She was then diagnosed with TEN and admitted to the Pediatric Intensive Care Unit (PICU) and treated by a multidisciplinary team with antibiotics, systemic steroids, antihistamines, wound care, and other medications. The child's fever subsided and her skin and oral lesions gradually regenerated. She was discharged after twelve days of hospitalization as she improved clinically and symptomatically. TEN is a dermatological emergency that should be diagnosed and treated promptly to minimize the fatal outcome of the disease.

ChatGPT versus clinician: challenging the diagnostic capabilities of artificial intelligence in dermatology.

ChatGPT is an online language-based platform designed to answer questions in a human-like way, using deep learning -technology. To examine the diagnostic capabilities of ChatGPT using real-world anonymized medical dermatology cases. Clinical information from 90 consecutive patients referred to a single dermatology emergency clinic between June and December 2022 were examined. Thirty-six patients were included. Anonymized clinical information was transcribed and input into ChatGPT 4.0 followed by the question 'What is the most likely diagnosis?' The suggested diagnosis made by ChatGPT was then compared with the diagnosis made by dermatology. After inputting clinical history and examination data obtained by a dermatologist, ChatGPT made a correct primary diagnosis 56% of the time (n = 20). Using the clinical history and cutaneous signs recorded by nonspecialists, it was able to make a correct diagnosis 39% of the time (n = 14). This was similar to the diagnostic rate of nonspecialists (36%; n = 13), but it was much lower than that of dermatologists (83%; n = 30). There was no differential offered by referring sources 28% of the time (n = 10), unlike ChatGPT, which provided a differential diagnosis 100% of the time. Qualitative analysis showed that ChatGPT offered responses with caution, often justifying its reasoning. This study illustrates that while ChatGPT has a diagnostic capability, in its current form it does not significantly improve the diagnostic yield in primary or secondary care.

Correlations between histopathologic findings, serum biomarker levels, and clinical outcomes in Stevens–Johnson syndrome/toxic epidermal necrolysis (SJS/TEN)

Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe dermatological emergencies. The role of cytokines and chemokines in the pathogenesis, progression of the disease, and histopathologic features is not fully elucidated. To address this gap, we conducted a retrospective study examining the associations between 42 serum biomarkers, histopathologic findings, and clinical outcomes in SJS/TEN patients. We reviewed the medical records of 23 patients diagnosed with SJS/TEN. Regarding histopathology, our study did not reveal any significant associations between the degree of epidermal necrosis, dermal mononuclear cell infiltration, and clinical outcomes. However, an intriguing observation was made regarding the degree of dermal infiltration of CD8 + cells, which showed a negative correlation with the severity of acute ocular complications. Notably, serum levels of IFN-γ positively correlated with the number of CD8 + cells in dermal infiltration. Additionally, higher serum levels of myeloperoxidase were associated with greater degrees of epidermal necrosis, while serum Fas ligand and stem cell factor levels were elevated in individuals with increased dermal mononuclear cell infiltration. Furthermore, the levels of S100A8/A9 were significantly correlated with the SCORTEN and mortality rate. These findings provide insights into the intricate pathogenesis of the disease.

Lamotrigine-induced Stevens-Johnson Syndrome Toxic Epidermal Necrolysis (SJS/TEN) overlap with transaminitis in an Asian female: a case report

Background: Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis (SJS/TEN) is a dermatologic emergency characterized by extensive epidermal detachments. The most frequent etiology is drug reaction within an interval of the last 8 weeks. SJS/TEN may occur in any age, race, and gender; however, there is an increased risk in patients over 65. SJS and TEN are differentiated based on the extent of epidermal detachments, which is &lt;10% in SJS, 10-30% in SJS-TEN overlap, and &gt;30% in TEN. This case study aims to evaluate the Lamotrigine-induced Stevens-Johnson Syndrome Toxic Epidermal Necrolysis (SJS/TEN) overlap with transaminitis in an Asian female. Case Presentation: A 34-year-old woman presented with a pruritic and burning rash on almost all body parts. The suspected causative drug was lamotrigine, which she consumed within the last 2 weeks. Mucosal involvement was also found on the lips and genital mucosal. The affected body surface area was approximately 20%, with a positive Nikolsky sign. Laboratory studies showed elevated liver function tests. Based on the history, physical examination, and biopsy, the patient was diagnosed with SJS/TEN overlap. The suspected causative drug was immediately stopped, and supportive and systemic corticosteroid treatments were provided. The SCORTEN was 2, with a mortality rate of 12.1%. After a few days, the patient's condition had improved, the liver function test was normal, and there was no significant complication. Conclusion: SJS-TEN is a part of epidermal necrolysis, characterized by an extensive epidermal detachment. The management of SJS/TEN includes early detection, immediately stopping the suspected drugs, administering systemic corticosteroids, and other supportive treatments.

Association of Acetaminophen With Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: Pharmacologic Considerations and Treatment Options.

Acetaminophen is an extremely common drug with many implications for its analgesic and antipyretic properties. It has a unique mechanism of action and downstream effects that separate it categorically from non-steroidal anti-inflammatory drugs. These differences come with potential adverse effects that range from mild drug reactions to severe life-threatening emergencies. While acetaminophen's toxic liver effects are well known, a lesser-known adverse effect of this drug is its association with the development of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). These dermatological emergencies involve similar pathological processes, including apoptosis of the epidermis and sloughing of the dermis and mucosa from the underlying layers with a positive Nikolsky sign. Currently, SJS and TENare considered immune-mediated type IV hypersensitivity reactions predominantly involving CD8+ T lymphocytes. Other immune mediators, including regulatory T cells, natural killer cells, interleukins, and drug metabolites are speculated to be involved, but their mechanisms have not been entirely determined.These conditions are differentially diagnosed by the percentage of body area affected with SJS and TENS, involving <10% and >30%, respectively. Genomic variations in human leukocyte antigens (HLA)genes have been implicated in the susceptibility and severity of acetaminophen-induced SJS/TENS, however, details of these interactions remain unclear. Acetaminophen's widespread use and the morbidity of its associated skin pathologies SJS and TENS warrant an in-depth examination of the causative processes involved in their pathogenesis. It is critical that both physicians and patients be made aware that while acetaminophen is widely tolerated by most individuals, severe and potentially fatal interactions do occur, and further investigation is necessary to reduce these adverse effects.

A retrospective study to describe the clinical pattern of dermatologic lesions from the pediatric emergency department: our experience from a tertiary care hospital in Turkey

ABSTRACT Background and objectives Dermatologic lesions that occur primarily or are secondary to disease are among the most common reasons for referral to the Pediatric Emergency Department (PED). This study aims to reveal the clinical features, diagnostic distribution, and management of patients who presented to the PED with dermatologic lesions Methods The study was a retrospective cross-sectional study involving children aged 0–18 years who presented to Gazi University Faculty of Medicine, PED, in 2018 with dermatologic lesions. The SPSS−20 program was used for data analysis. Results A total of 1590 patients, 57.8% (919) male, were included in the study. The median age was 75 (minimum: 4 days; maximum: 17 years, 11 months) months. The frequency of dermatologic lesions was 4.33% (433/10,000). Allergic and infectious dermatologic lesions, which are the two most common skin lesions in all age groups, were seen in 46.2% (735) and 30.5% (485) (patients, respectively. Urticaria (n = 588, 37%) was the most common in allergic rashes, and viral rashes (n = 162, 10.2%) were the most common in infectious rashes. Ninety-four percent (1495) of the patients were discharged from the PED. Two patients were hospitalized and followed up as dermatologic emergencies. Conclusion Urticaria and viral eruptions are common dermatologic lesions in our PED. Both conditions are easily recognized and treated by physicians. Most lesions do not require hospitalization. Dermatologic emergencies, although rare, should be well-known to physicians.

Assessing the Ability of Non-dermatology Physicians to Recognize Urgent Skin Diseases.

Introduction Many patients present to the emergency department with skin conditions that are not true dermatologic emergencies. Urgent skin conditions are uncommon. Because these conditions are rare, they can be sometimeschallenging to diagnose. Few works of literature discussed the accuracy of non-dermatologists' initial judgment on dermatologic conditions concluding that non-dermatologists misdiagnose many common and uncommon skin conditions. Because the study was never done in our region, we aim to conduct an online assessment using a questionnaire assessing the ability of non-dermatologists to recognize urgent skin diseases at King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia. Methods A cross-sectional study was conducted. Non-dermatologist physicians were contacted through their verified emails, provided by the secretaries of each department and the academic affairs unit. The questionnaire consisted of two main sections, the first section covered demographics, specialty, and academic level. The second part had eight questions, each containing a brief case scenario about an urgent dermatological condition with a picture of the condition attached. Participants were required to answer the questions and assess on a scale from one to 10 how confident they were about their answers. The responses were collected and analyzed. Results Out of all 161 responses, this study included 93 male physicians (57.8%) and 68 female physicians (42.2%). The mean age in the study was approximately 45 ± 3 years. This study showed that the percentage of accuracy by non-dermatologists in diagnosing urgent skin diseases given the typical presentation of the condition was (61.33%); nevertheless, the percentage decreased when it was recalculated in relation to the full level of confidence to (25.3%). Herpes zoster appeared to be the most recognizable urgent skin disease, and Pemphigus vulgaris was the least recognizable one. Conclusion This study shows that it is difficult for physicians to recognize some urgent skin diseases, which affects offering the optimum health care for the patients. Moreover, more dermatology-focused courses are needed to strengthen the knowledge about dermatological diseases.

An Uncommon Presentation of Vasopressin-Induced Purpura Fulminans

Purpura fulminans (PF) is a rarely encountered rapidly evolving dermatological manifestation of ischemia, particularly in critically ill patients. Considered one of the very few dermatological emergencies, it has high mortality rate where patients often succumb to the illness. It can manifest in three forms: neonatal, idiopathic, and the more commonly infectious variety, which can be secondary to mostly bacterial and rarely viral etiology. It is also reported to be highly associated with disseminated intravascular coagulation (DIC), heparin-induced thrombocytopenia (HIT), and acute hepatic failure (AHF). Hereditary or acquired deficiency of protein C and dysregulation of the coagulation cascade, mainly protein C-thrombomodulin, has been implicated in the pathogenesis. We present a 55-year-old male admitted to the intensive care unit for diabetic ketoacidosis (DKA) and septic shock. Along with initiating management protocol for DKA and broad-spectrum antibiotics, he was initially started on norepinephrine for septic shock. Because of persistent refractory septic shock, he was subsequently initiated on phenylephrine and vasopressin to maintain adequate perfusion. The following day, he was found to have sharply demarcated blackish non-blanching discoloration on bilateral knees, lower limbs, and scrotum, sparing the acral regions. This cutaneous manifestation persisted throughout his hospital course, although it improved after discontinuation of vasopressin while continuing with other pressors. Vasopressin has been implicated in a few instances of skin necrosis; however, PF has rarely been documented and never within 1 day like ours. This case demonstrates a unique development of PF likely from vasopressin after ruling out the diagnoses of DIC, HIT, thrombotic thrombocytopenic purpura, and AHF.

Resultados académicos durante el período epidémico en la Facultad de Ciencias Médicas Miguel Enríquez

Introduction: The years 2020 and 2021 were characterized by the COVID-19 epidemic in Cuba, which led to the adaptation of academic courses with the premise of flexible learning processes, through the suspension of in-person activities and modification of the teaching curriculum. Objective: To describe the results of the state exam during the epidemic period. Methods: An observational, descriptive, retrospective study was conducted based on the analysis of promotion reports and official models 36.19 and 36.20 from the Postgraduate Directorate for the years 2020-2021. Results: A total of 173 residents were presented for the state exam, 111 from medical specialties and 62 from stomatological specialties, all of whom passed with a 100% promotion rate. Of those who took the state exam, 49.7% obtained final grades above 95 points, and 78.0% obtained grades above 90 points. Residents in the specialties of Dermatology and Intensive and Emergency Medicine obtained the best academic results. Conclusions: The Miguel Enríquez Faculty of Medical Sciences graduated all residents presented for the state exam during the epidemic period with quality education.