Pereira A R, Porro A M, Seque C A, Pasin V P, Tomimori J
Servicio de Dermatología, Universidad Federal de São Paulo, Sao Paulo, Brasil.
Servicio de Dermatología, Universidad Federal de São Paulo, Sao Paulo, Brasil.
Actas Dermosifiliogr (Engl Ed). 2018 Dec;109(10):900-907. doi: 10.1016/j.ad.2018.07.009. Epub 2018 Oct 22.
Renal transplant recipients (RTR), which are an increasing population, frequently suffer from post-transplant dermatological complications. Despite the well-established role of dermatologists in the outpatient care of these patients, no previous studies were found concerning dermatology consultations for hospitalized RTR.
To investigate the epidemiology of dermatological conditions presented by RTR during hospitalization and assess the impact of dermatology consultations performed in the hospital setting.
Dermatology consultations requested for RTR admitted at a kidney transplantation referral hospital in Brazil over 36 consecutive months were retrospectively included.
176 consultations were included. Infectious dermatoses prevailed (52.3%), followed by inflammatory diseases (14.2%), neoplasms (12.5%) and drug reactions (8.5%). Diagnostic agreement between requesting and consulting teams was 38.1%. Most consultations were motivated by common dermatological conditions, unrelated to admission diagnosis. There were some differences in comparison to previous studies including general inpatients, such as: larger proportion of infectious dermatoses and neoplasms, smaller proportion of inflammatory diseases, higher percentage of patients submitted to skin biopsy, smaller proportion of consultations managed with a single visit and higher probability of a systemic treatment being recommended in this population.
Hospitalized RTR present distinct dermatological epidemiology and higher level of complexity, when compared to studies including general inpatients. Dermatology interventions during hospitalization may be beneficial in the multidisciplinary care of these patients, either contributing to the investigation of systemic conditions or providing relief for cutaneous comorbidities.
肾移植受者(RTR)群体日益壮大,常遭受移植后皮肤并发症。尽管皮肤科医生在这些患者的门诊护理中发挥着既定作用,但此前未发现有关住院RTR皮肤科会诊的研究。
调查住院期间RTR出现的皮肤病流行病学情况,并评估在医院环境中进行皮肤科会诊的影响。
回顾性纳入巴西一家肾脏移植转诊医院连续36个月收治的RTR所要求的皮肤科会诊。
共纳入176例会诊。感染性皮肤病占主导(52.3%),其次是炎症性疾病(14.2%)、肿瘤(12.5%)和药物反应(8.5%)。申请团队与会诊团队之间的诊断一致性为38.1%。大多数会诊是由常见皮肤病引起的,与入院诊断无关。与之前包括普通住院患者的研究相比存在一些差异,例如:感染性皮肤病和肿瘤的比例更高,炎症性疾病的比例更低,接受皮肤活检的患者百分比更高,单次就诊处理的会诊比例更低,以及在该人群中推荐进行全身治疗的可能性更高。
与包括普通住院患者的研究相比,住院RTR呈现出不同的皮肤病流行病学特征和更高的复杂性水平。住院期间的皮肤科干预可能有利于这些患者的多学科护理,要么有助于全身性疾病的调查,要么为皮肤合并症提供缓解。