J. Lai-Kwon , T. Weiland , A.H. Chong
Introduction: Dermatology is primarily an outpatientbased speciality in Australia. To our knowledge, no studies have attempted to characterise the type and frequency of skin conditions presenting to an adult Emergency Department (ED) in Australia.
Objectives: To provide demographic and clinical data on the types of dermatological problems that present to a tertiary ED at St Vincent ’ s Hospital Melbourne over a 3 year retrospective period.
Methods: All ED visits between 1 January 2009 and 31 December 2011 were extracted from the hospital database. Dermatological presentations were identiﬁ ed by searching for keywords in ‘Presenting Complaint’ and ‘Triage Notes’ ﬁ elds and searching by ICD10 diagnosis codes. The epidemiological and patient demographics of these patients were analysed.
Results: Out of 124 081 total presentations to ED, 4817 patients had a primarily dermatological complaint (3.89%). Commonest presenting conditions were cellulitis (36.14%), allergy with skin involvement including urticaria and angioedema (19.5%), boils/abscesses/furuncles/carbuncles/pilonidal sinuses (11.13%), eczema (5.69%), varicella zoster infections (3.34%), non-speciﬁ c skin infections (2.8%). 936 (19.43%) patients required inpatient admission. Commonest conditions requiring admission were cellulitis (56.09%), boils/abscesses/furuncles/carbuncles/pilonidal sinuses (19.02%), non-speciﬁ c skin infections (3.42%), psoriasis (3.10%), eczema (2.88%), impetigo (2.35%), nonspeciﬁ c rashes (1.6%), varicella zoster infections (1.39%).
Conclusion: This preliminary data shows that skin conditions represent a small proportion of all dermatological presentations to ED. High prevalence conditions such as cellulitis, abscesses and urticaria should be the focus of emergency medicine dermatological curricula in order to improve the recognition and initial management of the most common skin complaints.