title: Inpatient dermatology consultation aids diagnosis of cellulitis among hospitalized patients: A multi-institutional analysis.
abstract: BACKGROUND
  Given its nonspecific physical examination findings, accurately distinguishing cellulitis from a cellulitis mimicker (pseudocellulitis) is challenging.
  
  
  OBJECTIVE
  We sought to investigate the national incidence of cellulitis misdiagnosis among inpatients.
  
  
  METHODS
  We conducted a retrospective review of inpatient dermatology consultations at Massachusetts General Hospital, University of Alabama at Birmingham Medical Center, University of California Los Angeles Medical Center, and University of California San Francisco Medical Center in 2008. All consults requested for the evaluation of cellulitis were included. The primary outcomes were determining the incidence of cellulitis misdiagnosis, evaluating the prevalence of associated risk factors, and identifying common pseudocellulitides.
  
  
  RESULTS
  Of the 1430 inpatient dermatology consultations conducted in 2008, 74 (5.17%) were requested for the evaluation of cellulitis. In all, 55 (74.32%) patients evaluated for cellulitis were given a diagnosis of pseudocellulitis. There was no statistically significant difference in the rate of misdiagnosis across institutions (P = .12). Patient demographics and associated risk factor prevalence did not statistically vary in patients given a diagnosis of cellulitis versus those with pseudocellulitis (P > .05).
  
  
  CONCLUSIONS
  This study was unable to evaluate all patients admitted with cellulitis and was conducted at tertiary care centers, which may affect the generalizability of the results.
  
  
  CONCLUSIONS
  Cellulitis is commonly misdiagnosed in the inpatient setting. Involving dermatologists may improve diagnostic accuracy and decrease unnecessary antibiotic use.
authors.affiliation: Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Lauren
authors.initials: L
authors.lastname: Strazzula
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Cotliar
authors.affiliation: University of California San Francisco Medical Center, San Francisco, California.
authors.forename: Lindy P
authors.initials: LP
authors.lastname: Fox
authors.affiliation: University of Alabama at Birmingham Medical Center, Birmingham, Alabama.
authors.forename: Lauren
authors.initials: L
authors.lastname: Hughey
authors.affiliation: University of California San Francisco Medical Center, San Francisco, California.
authors.forename: Kanade
authors.initials: K
authors.lastname: Shinkai
authors.affiliation: University of California Los Angeles Medical Center, Los Angeles, California.
authors.forename: Sarah N
authors.initials: SN
authors.lastname: Gee
authors.affiliation: Massachusetts General Hospital, Boston, Massachusetts. Electronic address: dkroshinsky@mgh.harvard.edu.
authors.forename: Daniela
authors.initials: D
authors.lastname: Kroshinsky
mesh_terms: D002481:Cellulitis / Q000175:diagnosis*; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
keywords: antibiotics; cellulitis; contact dermatitis; internal medicine; medical dermatology; skin and soft-tissue infections; stasis dermatitis