Characterisation and diagnosis of ulcers in inpatient dermatology consultation services

A multi-centre study

Dylan Haynes, Phoebe Hammer, Stephen J. Malachowski, Benjamin Kaffenberger, Jonathan S. Yi, Nora Vera, Cody Calhoun, Michi M. Shinohara, Lucia Seminario-Vidal, John C. Trinidad, Jesse J. Keller, Alex Ortega Loayza

Research output: Contribution to journalArticle

Abstract

Accurate and prompt diagnosis of skin ulcers is critical to optimise management; however, studies in hospitalised patients are limited. This retrospective review of dermatologic consultations included 272 inpatients with skin ulcers between July 2015 and July 2018 in four U.S. academic hospitals. The median age was 54 years and 45% were male. In 49.3% of the patients, skin ulcers were considered the primary reason for admission. Ulcers of 62% were chronic and 49.6% were located on the lower extremities. Pyoderma gangrenosum (17.3%), infection (12.5%), and exogenous causes (11.8%) were the leading aetiologies; 12% remained diagnostically inconclusive after consultation. Diagnostic agreements pre-dermatology and post-dermatology consult ranged from 0.104 (n = 77, 95% CI 0.051-0.194) to 0.553 (n = 76, 95% CI 0.440-0.659), indicating poor-modest agreement. This study highlights the diagnostic complexity and relative incidences of skin ulcers in the inpatient setting.

Original languageEnglish (US)
JournalInternational Wound Journal
DOIs
StateAccepted/In press - Jan 1 2019

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Skin Ulcer
Dermatology
Ulcer
Inpatients
Referral and Consultation
Pyoderma Gangrenosum
Lower Extremity
Incidence
Infection

Keywords

  • dermatology
  • inpatient
  • pyoderma gangrenosum
  • ulcer

ASJC Scopus subject areas

  • Surgery
  • Dermatology

Cite this

Characterisation and diagnosis of ulcers in inpatient dermatology consultation services : A multi-centre study. / Haynes, Dylan; Hammer, Phoebe; Malachowski, Stephen J.; Kaffenberger, Benjamin; Yi, Jonathan S.; Vera, Nora; Calhoun, Cody; Shinohara, Michi M.; Seminario-Vidal, Lucia; Trinidad, John C.; Keller, Jesse J.; Ortega Loayza, Alex.

In: International Wound Journal, 01.01.2019.

Research output: Contribution to journalArticle

Haynes, D, Hammer, P, Malachowski, SJ, Kaffenberger, B, Yi, JS, Vera, N, Calhoun, C, Shinohara, MM, Seminario-Vidal, L, Trinidad, JC, Keller, JJ & Ortega Loayza, A 2019, 'Characterisation and diagnosis of ulcers in inpatient dermatology consultation services: A multi-centre study', International Wound Journal. https://doi.org/10.1111/iwj.13211
Haynes, Dylan ; Hammer, Phoebe ; Malachowski, Stephen J. ; Kaffenberger, Benjamin ; Yi, Jonathan S. ; Vera, Nora ; Calhoun, Cody ; Shinohara, Michi M. ; Seminario-Vidal, Lucia ; Trinidad, John C. ; Keller, Jesse J. ; Ortega Loayza, Alex. / Characterisation and diagnosis of ulcers in inpatient dermatology consultation services : A multi-centre study. In: International Wound Journal. 2019.
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