title: Primary care and pattern of skin diseases in a Mediterranean island.
abstract: BACKGROUND
  In Greece where primary health care services are not fully developed, patients with simple or minor conditions have to attend to hospitals to be treated. We analysed the data of patients with cutaneous disorders attending the tertiary referral hospital on the Island of Crete, with the aim to identify the most common conditions that patients complain of, in order to define the areas where the education of General Practitioners in Dermatology must focus.
  
  
  METHODS
  All patients attending the Dermatology ambulatory office in the Emergency Department of the University General Hospital of Heraklion from January 2003 to December 2003 were included in this retrospective analysis. The medical records of the patients (history, physical examination and laboratory investigations) were analysed to ascertain the diagnosis and the management of cases. All patients were evaluated by qualified dermatologists.
  
  
  RESULTS
  A total of 3715 patients attended the Dermatology Clinic. Most patients were young adults in the age group 21-40 years (38.4%), and the male to female ratio was 1 to 1.2. Allergic skin diseases, mostly dermatitis and urticaria (35.7%) were the most common for attendance, followed by infectious diseases (26.1%) and insect bites (10.2%). Inflammatory and autoimmune disorders accounted for 7.9% of the cases. Pruritus of unknown origin was diagnosed in 6.3% of patients. Skin tumors were detected in 2.7%. The management of the vast majority of cases (85.0%) consisted of advice with or without a prescription, while only 4.8% of patients required admission.
  
  
  CONCLUSIONS
  Allergic and infectious skin diseases were the most common cutaneous diseases in patients attending this tertiary University hospital, while the management of most patients did not require specialised care. On the basis of the present data, the training of primary health care providers in Dermatology should emphasize these common conditions, with the aim of improving primary care and alleviating the burden on hospital care.
authors.affiliation: Department of Social Medicine, Faculty of Medicine, University of Crete, Greece. symvouman@yahoo.com
authors.forename: Emmanouil K
authors.initials: EK
authors.lastname: Symvoulakis
authors.forename: Konstantin
authors.initials: K
authors.lastname: Krasagakis
authors.forename: Ioannis D
authors.initials: ID
authors.lastname: Komninos
authors.forename: Ioannis
authors.initials: I
authors.lastname: Kastrinakis
authors.forename: Ioannis
authors.initials: I
authors.lastname: Lyronis
authors.forename: Anastasios
authors.initials: A
authors.lastname: Philalithis
authors.forename: Androniki D
authors.initials: AD
authors.lastname: Tosca
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003880:Dermatology / Q000193:education; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005194:Family Practice / Q000193:education; D005260:Female; D006115:Greece / Q000453:epidemiology; D006300:Health Services Misuse; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D011320:Primary Health Care / Q000592:standards / Q000639:trends*; D012871:Skin Diseases / Q000145:classification / Q000453:epidemiology* / Q000628:therapy; D014600:Utilization Review