Dermatological presentations to a regional Victorian hospital emergency department: A 1‐year audit. (20th October 2022)

• Record Type: Journal Article
• Authors: Ronaldson, Claire; Zhou, Kelly; Lam, Michael; Ong, Dillon; Morgan, Sian; Sathe, Aditya; Isaacs, Anton N.
• Is Part Of: Australian journal of rural health. Volume 31:Number 2(2023)
• Page Start: 196
• Page End: 203
• Publication Date: 2022-10-20
• Subjects: cellulitis -- ED -- emergency department -- indigenous Australian -- rural and remote -- skin infection -- skin or dermatologic conditions; Rural health -- Periodicals; Rural health -- Australia -- Periodicals; 613
• DOI: 10.1111/ajr.12935
• Languages: English
• ISSNs: 1038-5282

Abstract

Abstract: Objectives: The objective of this study is to describe the epidemiological features of each presentation with a primary dermatological diagnosis to a regional emergency department (ED). Design: 1‐year retrospective audit. Setting: Regional Victorian hospital emergency department. Participants: Any presentation to this regional emergency department with a dermatological condition from 1 January 2020 to 31 December 2020. Main Outcome Measures: Dermatology presentations to the ED in 2020 and the prevalence of the associated primary diagnosis. Results: In total, 4.7% ( n = 1873) of ED presentations had a primary dermatological diagnosis. Of these, 1484 were ≥18 years of age and 389 were ≤17 years of age. Cellulitis (26.1%, n = 388) was the most common primary diagnosis among presentations ≥18 years. Non‐specific rash was the most common diagnosis (23.6%, n = 92) in presentations ≤17 years. Indigenous Australians ≥18 years were more likely to be in a younger age group ( p < 0.01), and dermatitis/eczema presentations ≥18 years ( n = 10) were the largest diagnostic group referred to a dermatologist. A total of 134 (7.1%) patients ≥18 years travelled more than 50 km to the ED. There were no dermatological emergencies identified. Conclusions: A high proportion of presentations to this regional ED with a dermatological diagnosis could be well managed by a dermatologist or general practitioner (GP) as an outpatient. The findings of this study inform the need for future rural public dermatology services. Options include teledermatology, or a public weekly or fortnightly rapid review dermatology clinic with a visiting dermatologist, in the absence of a dermatologist onsite.