Emergency Consultations in Dermatology in a Secondary Referral Hospital in Southern Switzerland: A Prospective Cross-Sectional Analysis

Background/Aims: The spectrum of dermatological emergencies is broad. Only a few studies have assessed the profile of dermatological conditions resulting in an emergency visit in a referral hospital. We sought to assess the conditions prompting an urgent dermatological visit and to compare the diagnoses with those made during the regular scheduled encounters. Methods: We performed a cross-sectional study of all patients with a cutaneous problem attending our emergency consultation during a 7-month period. The study variables were gender, age, duration of symptoms, diagnosis, need for hospitalization and/or follow-up. We further evaluated patients attending scheduled visits to compare the demographic characteristics and diagnoses between the two groups. Results: Six hundred fifty-two consecutive patients with an urgent dermatological consultation were included. Three hundred sixty (55.2%) were women and 292 (44.8%) were men. Infectious diseases (32.8%) as well as various forms of eczema (24.8%) constituted the most frequent causes for an emergency visit. Approximately 40% of emergency visits took place more than 1 week after the development of the cutaneous manifestations. The most frequent disorders seen in the 1,738 control patients included benign melanocytic and nonmelanocytic tumors (27.2%) and malignant skin lesions (11.5%). Conclusions: Our study indicates that the dermatological diagnoses in the emergency visits significantly differ from those of the routinely scheduled appointments. In a significant portion of patients, the use of an emergency consultation was not justified. This study provides support to the idea that a specific training is required to manage dermatological emergencies and that efforts should be made to reduce unjustified emergency visit use.

Download Full-text

Dermoscopy and Trichoscopy in Dermatomyositis—A Cross-Sectional Study

Journal of Clinical Medicine ◽

10.3390/jcm11020375 ◽

2022 ◽

Vol 11 (2) ◽

pp. 375

Author(s):

Magdalena Żychowska ◽

Adam Reich

Keyword(s):

Diagnostic Technique ◽

Skin Lesions ◽

Cross Sectional Study ◽

Cutaneous Lesions ◽

Cross Sectional ◽

Cutaneous Manifestations ◽

Non Invasive ◽

Inflammatory Dermatoses ◽

Curved Vessels ◽

Established Role

Background: (Video)dermoscopy is a non-invasive diagnostic technique that has a well-established role in dermatooncology. In recent years, this method has also been increasingly used in the assessment of inflammatory dermatoses. So far, little is known about the (video)dermoscopic features of dermatomyositis (DM). Methods: Consecutive patients with DM were included in the study and videodermoscopic assessments of the nailfolds, scalp, and active skin lesions were performed. Results: Fifteen patients with DM (10 women and 5 men) were included. Capillaroscopy showed elongated capillaries (90.9%), avascular areas (81.8%), disorganized vessel architecture (81.8%), tortuous capillaries (72.7%), dilated capillaries (72.7%), and hemorrhages (72.7%). The trichoscopic findings included linear branched vessels (80.0%), linear vessels (60.0%), linear curved vessels (53.3%), perifollicular pigmentation (40.0%), perifollicular erythema (33.3%), scaling (20.0%), white (20.0%) or yellow (20%) interfollicular scales, and white (20.0%) or pinkish (13.3%) structureless areas. Polymorphic vessels of an unspecific distribution and white or pink structureless areas were frequently observed under dermoscopy in cutaneous manifestations of DM, including Gottron’s papules and Gottron’s sign. Conclusions: Dermoscopy of the nailfolds (capillaroscopy), scalp (tricoscopy), and active cutaneous lesions may be of value in the preliminary diagnosis of DM.

Download Full-text

Dermatological Manifestation in Coronavirus Disease 2019 Patients in Iraq

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.7095 ◽

2021 ◽

Vol 9 (B) ◽

pp. 1085-1091

Author(s):

Anfal L. Al-Harbawi ◽

Qasim S. Al Chalabi ◽

Hala N. Alsalman ◽

Mohammad S. Saeed

Keyword(s):

Early Recognition ◽

Cutaneous Lesion ◽

Maculopapular Rash ◽

Skin Lesions ◽

Cross Sectional Study ◽

Prodromal Phase ◽

Cross Sectional ◽

Cutaneous Manifestations ◽

High Incidence ◽

Common Skin

Background: Coronavirus disease-19 (COVID-19) is a growing pandemic around the globe that was initially discovered in Wuhan in December 2019. Despite the relatively high incidence of cutaneous manifestations in COVID-19, their role in early recognition and disease progression has not been fully investigated. Aim of this study: To report the possible incidence of the cutaneous lesion in COVID 19 patients and to describe various cutaneous manifestations and their correlation with other clinical features in Covid-19 positive patients to facilitate diagnosis and prognostications toward this virus. Methods: This research was conducted as a cross-sectional study. Skin lesions photography and their analysis were collected by dermatologists from 18 cities in Iraq between September 2020 to January 2021. The data were processed using statistical package SPSS version 23. Results: A total of 3117 confirmed COVID-19 cases were included in this study. Around 268 patients developed skin lesions with age ranged between 8 to 84 years. Of these skin lesions, 46.2% developed during the illness with minority erupting during the prodromal phase, whilst 38.8% appeared after hospitalization. The most common skin lesion was in the form of urticarial 36.74% followed by herpetic lesions 28.4%, maculopapular rash 11.74% and the remainder being candidiasis, oral thrush, chilblains, and other skin conditions. The most affected area was the torso (46%) followed by limbs, face, fingers, and toes. Conclusion: This study demonstrated the high incidence rate of dermatological lesions in different phases of COVID-19 with urticarial rash being the most frequent clinical pattern.

Download Full-text

Cutaneous manifestations in COVID-19 patients in a district COVID care centre

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20214205 ◽

2021 ◽

Vol 7 (6) ◽

pp. 805

Author(s):

Prathyusha Dasari ◽

Swetha A. Chowdary ◽

Haritha Samanthula ◽

Soumya Ruvva

Keyword(s):

Case Reports ◽

Severe Disease ◽

Respiratory Illness ◽

Maculopapular Rash ◽

Skin Lesions ◽

Cross Sectional Study ◽

Cross Sectional ◽

Cutaneous Manifestations ◽

Skin Manifestations ◽

Indian Scenario

Background: COVID-19, initially started as respiratory illness and evolved to involve various systems. Skin has been the least targeted organ with manifestations limited to case reports and series in a foreign scenario. Here, we tried to understand a same in an Indian scenario.Methods: This was cross-sectional study done in district COVID centre among patients with a confirmed diagnosis of COVID-19 with cutaneous manifestations for 3 months. A detailed history, complete cutaneous examination was carried out. Timing in relation to other symptoms and severity was assessed.Results: Among the 1603 patients, 39 (2.4%) had skin manifestations. Urticaria (20.5%), petechiae/purpura (17.9%), pruritis (15.4%) were the most common followed by maculo-papular rash (7.7%), manifestations secondary to drugs (7.7%), diffuse hair fall (7.7%), pseudo-chilblains (5.1%), vesicular eruptions (5.1%), infections (5.1%), cellulitis, gangrene and livedoid vasculitis. Timing of skin lesions ranged from 2 days before (10.3%) onset of COVID-19 symptoms or diagnosis to 10 days after (69.2%). Urticaria, petechiae, maculopapular rash were seen more commonly in patients with fever and respiratory symptoms. Asymptomatic cases showed urticaria, petechiae and pseudo-chilblains. Majority were in mild and moderate disease and livedoid vasculitis patient had severe disease.Conclusions: Skin manifestations in COVID-19 are relatively uncommon in Indian scenario. However, few of the manifestations give a hint of infection while some correlate with the severity of disease.

Download Full-text

Cutaneous Lesions in Iranian Neonates and Their Relationships with Maternal-Neonatal Factors: A Prospective Cross-Sectional Study

Dermatology Research and Practice ◽

10.1155/2020/8410165 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5

Author(s):

Hossein Firouzi ◽

Iman Jalalimehr ◽

Zahra Ostadi ◽

Siavash Rahimi

Keyword(s):

Neonatal Period ◽

Skin Lesions ◽

Cross Sectional Study ◽

Common Source ◽

Sectional Study ◽

Cutaneous Lesions ◽

Cross Sectional ◽

Cutaneous Manifestations ◽

Therapeutic Procedures ◽

Maternal Disease

Cutaneous lesions are common in the neonatal period and mostly physiological, transient, and self-limited; uncommonly, they are pathological and require treatment and cooperation between neonatologists and dermatologists. Particular conditions, like prematurity, can influence the onset, type, and evolution of cutaneous manifestations. Of the several articles in the literature about skin findings in newborns, only a few were performed in Iran. We aimed to investigate dermatological findings in a sample of neonates within the first three days of life and to evaluate the association between skin lesions and neonatal- or maternal-related variables. A total of 1202 newborns, hospitalized in the Department of Pediatrics of Imam Sajjad Hospital of Ramsar and Shahid Rajaee Hospital of Tonekabon, Iran, for two years, were examined. All skin findings were recorded, and information on neonatal and maternal variables was collected and analyzed to detect statistically significant associations. Skin lesions were present in 958 newborns (79.8%). The prevalence of milia, erythema toxicum, salmon patch, and Mongolian spots were 45.2%, 43%, 37.3%, and 37%, respectively. Natural vaginal delivery, use of medication, term gestation, and maternal disease were associated with a higher incidence of cutaneous lesions in neonates. Milia, erythema toxicum, Mongolian spots, and genital hyperpigmentation were seen more frequently in the male gender. Conversely, skin desquamation was seen more frequently in females. Among maternal diseases, gestational diabetes mellitus, urinary tract infection, preeclampsia, hypertension, psychiatric disorders, and uterine infection were associated with a higher prevalence of cutaneous lesions. Neonatal cutaneous lesions are a common source of concern in parents and inexperienced physicians. Therefore, prompt recognition of neonatal cutaneous lesions is essential in order to avoid unnecessary diagnostic and therapeutic procedures.

Download Full-text

Suppurative Infections in Hospitalized Patients – An Ongoing MRSA Threat

Pakistan Journal of Medicine and Dentistry ◽

10.36283/pjmd9-1/012 ◽

2020 ◽

Author(s):

Sadaf Razzak

Keyword(s):

Staphylococcus Aureus ◽

Medical Science ◽

Great Influence ◽

Antibiotic Sensitivity ◽

Skin Lesions ◽

Cross Sectional Study ◽

Cross Sectional ◽

Inducible Clindamycin Resistance ◽

Empiric Antibiotic ◽

Medical Wards

Background: Penicillin resistance among Staphylococcus aureus commonly encountered in the hospital admitted patients. Detection of antibiotic sensitivity in hospital acquired methicillin resistant Staphylococcus aureus infections is important as it has great influence on empiric antibiotic prescription, successful control of infection, prevention of spread of disease and successful patient management. This study aimed to detect the frequency of HA-MRSA from pus samples in a hospital setup with assessment of their antibiotic susceptibility patterns. Method: A cross-sectional study was conducted in the Microbiology department of Basic Medical Science Institute, JPMC, Karachi from January 2015 until December 2015. Pus samples from surgical site wounds, skin lesions, abscesses from surgical and medical wards and ICUs were collected. According to the standards given by CLSI 2014, MRSA testing of the samples was done and susceptibility testing for antibiotics was performed. Inducible clindamycin resistance was detected by D-Test; E Test. determined MIC (minimum inhibitory concentration) for vancomycin. The data was analyzed by SPSS version 16. Result: Out of the 149 MRSA identified from the pus samples, 106 (71.14%) samples were HA-MRSA. The number of male patients was more than the female patients (67.66%). Out of the 106 HA-MRSA, 91(85.8%) were sensitive to TMP/SMX, 98(92.5%) to rifampicin, 12(11.6%) to gentamicin, 85(80.2%) to tetracycline, 11(10.4%) to erythromycin, 37(34.9%) to clindamycin, 20(18.9%) to ciprofloxacin, 106 (100%) to both vancomycin and linezolid. Conclusion: HA-MRSA showed sensitivity to TMP/SMX and vancomycin making them effective drugs to use in combination in superficial infections. The drug linezolid also showed 100% sensitivity.

Download Full-text

A Cross-Sectional Study to Evaluate Adherence to the Ten Steps to Successful Breastfeeding at a Referral Hospital in Rwanda

SSRN Electronic Journal ◽

10.2139/ssrn.3294101 ◽

2018 ◽

Author(s):

Janvier Hitayezu ◽

David Ntirushwa ◽

Jean Claude Ntiyamira ◽

Jeannette Kayitesi ◽

Rose Mary Murungi ◽

...

Keyword(s):

Cross Sectional Study ◽

Referral Hospital ◽

Sectional Study ◽

Cross Sectional

Download Full-text

Practice of spinal anesthesia among anesthetists in the operation room of referral hospital: Cross-sectional study

International Journal of Surgery Open ◽

10.1016/j.ijso.2020.11.002 ◽

2020 ◽

Vol 27 ◽

pp. 145-148

Author(s):

Yonas Admasu Ferede ◽

Yonas Addisu Nigatu ◽

Abatneh Feleke Agegnehu ◽

Salh Yalew Mustofa

Keyword(s):

Spinal Anesthesia ◽

Cross Sectional Study ◽

Referral Hospital ◽

Sectional Study ◽

Cross Sectional ◽

Operation Room

Download Full-text

Knowledge about self-care and associated factors among heart-failure patients in Ayder Referral Hospital, Ethiopia, 2018: A cross-sectional study

Proceedings of Singapore Healthcare ◽

10.1177/2010105820962141 ◽

2020 ◽

pp. 201010582096214

Author(s):

Tsegu Hailu Gebru ◽

Haftea Hagos Mekonen ◽

Kbrom Gemechu Kiros

Keyword(s):

Heart Failure ◽

New York ◽

Logistic Regression ◽

Self Care ◽

Heart Association ◽

Cross Sectional Study ◽

Referral Hospital ◽

Sectional Study ◽

Cross Sectional ◽

Knowledge Age

Background: Good knowledge of self-care related to heart failure (HF) is key to improve patient outcomes. However, information regarding how much patients know about self-care is lacking in developing countries, particularly in the study setting. Objective: The objectives of this study were to assess HF patients’ knowledge about self-care and to explore predictors among HF patients in Ayder comprehensive specialised referral hospital, Tigray, Ethiopia. Methods: This hospital-based cross-sectional study design was undertaken in Ayder comprehensive specialised referral hospital, Tigray, Ethiopia. A total of 408 HF patients participated, and the study was done between February and April 2018. An interviewer-assisted structured questionnaire was used to collect data. Bivariate logistic regression and multivariable logistic regression were conducted to identify the predictors associated with knowledge about self-care. Results: The mean age of the participants was 45.4 years (standard deviation=19 years). Around 255 (62.5%) of the participants had poor self-care knowledge. Age, New York Heart Association classes, duration of the disease and previous hospitalisation were the factors associated with knowledge about self-care. Conclusion: More than half of all participants had poor knowledge about self-care. Improving existing prevention strategies and strengthening patients’ knowledge are recommended to address this knowledge deficit.

Download Full-text