title: Dermatologic emergencies in a tertiary hospital: A descriptive study.
abstract: OBJECTIVE
  Dermatology in-house call is uncommon in the Spanish national health system. The objective of the present study was to define the groups of dermatologic diseases and conditions most frequently seen in the emergency department and to evaluate the need for dermatology in-house call in the training of medical residents.
  
  
  METHODS
  We performed a descriptive study of all patients who attended the emergency department with a skin complaint during a 1-year period (June 2013 to May 2014) and were assessed by 9 dermatology residents. The study variables were date/day, sex, age, diagnosis, special surgical procedures, additional laboratory tests, and need for hospitalization and/or follow-up. We also evaluated patients attending their first scheduled visit to the dermatologist between January and June 2014 in order to compare the most frequent conditions in both groups.
  
  
  RESULTS
  A total of 3084 patients attended the emergency room with a skin complaint (5.6% of all visits to the emergency department), and 152 different diagnoses were made. The most frequent groups of diseases were infectious diseases (23%) and eczema (15.1%). The specific conditions seen were acute urticaria (7.6%), contact dermatitis (6.1%), and drug-induced reactions (4.6%). By contrast, the most frequent conditions seen in the 1288 patients who attended a scheduled dermatology appointment were seborrheic keratosis (11.9%), melanocytic nevus (11.5%), and actinic keratosis (8%). A follow-up visit was required in 42% of patients seen in the emergency department. Fourth-year residents generated the lowest number of follow-up visits.
  
  
  CONCLUSIONS
  We found that infectious diseases and eczema accounted for almost 40% of all emergency dermatology visits. Our results seem to indicate that the system of in-house call for dermatology residents is very useful for the hospital system and an essential component of the dermatology resident's training program.
authors.affiliation: Departamento de Dermatología, Hospital Universitario de Salamanca, Salamanca, España. Electronic address: danielbancalari@hotmail.com.
authors.forename: D
authors.initials: D
authors.lastname: Bancalari-Díaz
authors.affiliation: Departamento de Dermatología, Hospital Universitario de Salamanca, Salamanca, España.
authors.forename: L I
authors.initials: LI
authors.lastname: Gimeno-Mateos
authors.affiliation: Departamento de Dermatología, Hospital Universitario de Salamanca, Salamanca, España; Instituto de Biología Molecular y Celular del Cáncer (IBMCC), Centro de Investigación del Cáncer (CIC), Salamanca, España.
authors.forename: J
authors.initials: J
authors.lastname: Cañueto
authors.affiliation: Departamento de Dermatología, Hospital Universitario de Salamanca, Salamanca, España.
authors.forename: I
authors.initials: I
authors.lastname: Andrés-Ramos
authors.affiliation: Departamento de Dermatología, Hospital Universitario de Salamanca, Salamanca, España; Instituto de Biología Molecular y Celular del Cáncer (IBMCC), Centro de Investigación del Cáncer (CIC), Salamanca, España.
authors.forename: E
authors.initials: E
authors.lastname: Fernández-López
authors.affiliation: Departamento de Dermatología, Hospital Universitario de Salamanca, Salamanca, España; Instituto de Biología Molecular y Celular del Cáncer (IBMCC), Centro de Investigación del Cáncer (CIC), Salamanca, España.
authors.forename: C
authors.initials: C
authors.lastname: Román-Curto
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003880:Dermatology / Q000193:education*; D003953:Diagnosis-Related Groups; D004485:Eczema / Q000453:epidemiology; D004630:Emergencies / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012871:Skin Diseases / Q000453:epidemiology* / Q000601:surgery; D012874:Skin Diseases, Infectious / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D062606:Tertiary Care Centers / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Dermatology in-house call; Dermatology training program; Emergency department; Epidemiology; Epidemiología; Formación en Dermatología; Guardias de Dermatología; Residentes; Residents; Urgencias