Bin Rubaian Nouf F, AlOmar Reem S, Alzahrani Ahmed S, Alotaibi Faleh M, Alharbi Mohammed A, Alanazi Bader S, Almuhaidib Serene R, Alsaadoon Nawaf F, Alfaraj Dunya, AlShamlan Nouf A
Dermatology Department, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Open Access Emerg Med. 2024 Nov 26;16:275-284. doi: 10.2147/OAEM.S468288. eCollection 2024.
Numerous dermatological conditions present in the emergency department (ED). Some have subtle presentations, yet most provoke patient suffering. Such conditions need to be identified and managed properly. This study aims to epidemiologically describe the patterns and characteristics of dermatological conditions presenting to a secondary teaching hospital's ED.
This retrospective chart review study analyses data on dermatological conditions that have presented to the ED between January 2021 and May 2023. The data gathered included sociodemographic variables, date and shift of visit, triage level, dermatological complaint characteristics, management, and discharge status. Comparative analysis was performed, and the level of significance was set at 0.05.
The total number of cases was 301. The median age was 12 years (IQR = 4-30 years), with similar distribution between males and females (50.17% and 49.83% respectively). Most cases had presented to the ED during the morning shift (49.83%). Triage levels IV and V made up 94.69%, and only 5.32% belonged to triage level III. Most presented during the winter season (32.89%). The median visit duration was 312 minutes, and of all cases treated, only 10 required a return visit to the ED. Also, 41.53% were discharged and 58.47% required further management. Maculopapular rashes were the most common finding (35.55%). Bullae/blisters and erythroderma accounted for those that most often required further management. The two most prescribed medications were topical steroids and antihistamines, followed by emollients (32.09% and 15.81%, respectively). Viral infections were the most reported complaint (22.26%) and only two patients complained of erythema multiforme (0.66%).
This study found that the majority of cases could have been managed by family physicians at a primary care setting. Also, epidemiological seasonal variations were observed where the majority of patients requiring further management had presented during the autumn season.
急诊科（ED）存在多种皮肤病情况。有些表现不明显，但大多数会给患者带来痛苦。这些情况需要得到正确的识别和处理。本研究旨在从流行病学角度描述一家二级教学医院急诊科就诊的皮肤病情况的模式和特征。
这项回顾性病历审查研究分析了2021年1月至2023年5月期间急诊科就诊的皮肤病情况数据。收集的数据包括社会人口统计学变量、就诊日期和班次、分诊级别、皮肤病主诉特征、处理方式和出院状态。进行了比较分析，显著性水平设定为0.05。
病例总数为301例。中位年龄为12岁（四分位间距 = 4 - 30岁），男性和女性分布相似（分别为50.17%和49.83%）。大多数病例在早班期间就诊于急诊科（49.83%）。IV级和V级分诊占94.69%，只有5.32%属于III级分诊。大多数在冬季就诊（32.89%）。中位就诊时长为312分钟，在所有接受治疗的病例中，只有10例需要返回急诊科就诊。此外，41.53%的患者出院，58.47%的患者需要进一步处理。斑丘疹是最常见的表现（35.55%）。水疱/大疱和红皮病是最常需要进一步处理的情况。最常开具的两种药物是外用类固醇和抗组胺药，其次是润肤剂（分别为32.09%和15.81%）。病毒感染是最常报告的主诉（22.26%），只有两名患者主诉有多形红斑（0.66%）。
本研究发现，大多数病例本可由基层医疗单位的家庭医生处理。此外，观察到了流行病学上的季节性变化，即大多数需要进一步处理的患者在秋季就诊。
