Wang E, Lim B L, Than K Y
Emergency Department, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore 308433.
Singapore Med J. 2009 Sep;50(9):881-4.
In Singapore, a significant proportion of patients receive specialist dermatological services via referrals from points of primary care, such as polyclinics and emergency departments (ED). The study hospital, Tan Tock Seng Hospital, is an acute care general hospital with a large catchment area, and has the busiest ED in Singapore. The aim of this paper was to describe the types of dermatological conditions presented at the ED in the year 2007. This information is useful for the future education of junior doctors working in the department, as well as for the allocation of future resources in the treatment of the more common conditions.
The ED patient database was searched for all dermatological conditions by ICD-9 code and by keywords in the diagnosis description. The two lists were merged and duplications were eliminated. The consultation notes of the patients were reviewed in cases where the diagnosis was ambiguous. Patient demographics were then filtered and analysed.
A total of 4,061 patients were seen in the ED with a primary dermatological complaint, out of a total of 157,527 attendances in 2007. The commonest conditions seen were chickenpox and herpes zoster (20.8 percent). Dermatitis/eczema (11.6 percent) and urticaria (11.4 percent), nail conditions including trauma and infections (10.2 percent) and drug rashes (9.7 percent) were also common. Venereal diseases (1 percent) were uncommonly seen in the ED. Interestingly, men (65.3 percent) were seen in the ED for dermatological conditions twice as often as women (34.7 percent).
The recognition and management of the common conditions should be core modules in the training of doctors and nurses.
在新加坡，相当一部分患者通过基层医疗点（如综合诊疗所和急诊科）的转诊接受皮肤科专科服务。研究医院——新加坡中央医院，是一家服务范围广泛的急症综合医院，拥有新加坡最繁忙的急诊科。本文旨在描述2007年急诊科所诊治的皮肤病类型。这些信息对于该科室年轻医生的未来教育以及未来治疗更常见疾病的资源分配都很有用。
通过国际疾病分类第九版（ICD - 9）编码以及诊断描述中的关键词，在急诊科患者数据库中搜索所有皮肤病病例。将这两个列表合并并消除重复项。对于诊断不明确的病例，查阅患者的会诊记录。然后对患者的人口统计学数据进行筛选和分析。
2007年急诊科共接待了157,527名患者，其中有4,061名患者以皮肤病为主诉前来就诊。最常见的疾病是水痘和带状疱疹（20.8%）。皮炎/湿疹（11.6%）、荨麻疹（11.4%）、包括外伤和感染在内的指甲疾病（10.2%）以及药物疹（9.7%）也较为常见。性病（1%）在急诊科较少见。有趣的是，因皮肤病前来急诊科就诊的男性（65.3%）是女性（34.7%）的两倍。
常见疾病的识别和管理应成为医生和护士培训的核心模块。
