Inpatient Consultative Dermatology

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Key points

  • Dermatology consultation aids in diagnosis and management of inpatients, while allowing for increased teaching of consulting services and time for patient and family education.

  • A broad range of skin disorders are seen by dermatologists in the inpatient setting, with overrepresentation by inflammatory and infectious dermatoses.

  • Common cutaneous infections can present with atypical or severe morphologies in immunosuppressed patients, and opportunistic infections can disseminate rapidly.

Why involve dermatology?

Dermatology consultation improves diagnostic accuracy. Dermatology consultation changes the diagnosis made by consulting teams frequently (45%–80% of patients), often leading to changes in treatment.3, 4, 5, 6 For example, when patients with suspected cellulitis were evaluated by dermatologists, cellulitis was confirmed in only 10%, potentially saving unnecessary antibiotic therapy and costly hospital stays.7 One-third of those with suspected cellulitis had alternative dermatoses, including

Common consultations seen by the inpatient dermatologist

The range of diagnoses that dermatologists see in the inpatient setting is broad, although in our experience inflammatory and infectious dermatoses are overrepresented, and series from other centers confirm this.6

Summary

Dermatology consultation can improve diagnostic accuracy in the hospitalized patient with cutaneous disease. Dermatology consultation can streamline and improve treatment plans, and potentially lead to cost savings. Dermatology consultants can be a valuable resource for education for trainees, patients, and families. Inpatient consultative dermatology spans a breadth of conditions, including inflammatory dermatoses, infectious processes, adverse medication reactions, and neoplastic disorders,

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    Disclosure Statement: The authors have nothing to disclose.

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