Bullous Impetigo Rapid Diagnostic and Therapeutic Quiz: A Model for Assessing Basic Dermatology Knowledge of Primary Care Providers.
OBJECTIVE
Bullous impetigo (BI) is a common dermatologic condition, particularly in children, yet confusion regarding its diagnosis and treatment persists. This study measured pediatricians' ability to diagnose and appropriately treat BI and explored factors that might influence pediatricians' accuracy in managing BI.


METHODS
We administered an expert-validated survey to 64 pediatrics house staff and faculty at three Johns Hopkins Medicine facilities. The survey requested demographic information, diagnoses for five "unknown" cases, and preferred treatments for localized and widespread BI.


RESULTS
Overall, BI was diagnosed correctly 31.9% of the time. There was little difference between house staff and faculty performance, although faculty 50 years of age and older demonstrated better diagnostic acumen. Regarding treatment of localized BI, 92% of faculty members and 84.6% of house staff listed mupirocin as first- or second-line treatment. The second most common medication listed for localized BI was bacitracin. Regarding treatment of widespread BI, faculty listed cephalexin or clindamycin as first- or second-line treatment 56.0% of the time and house staff listed one of these two medications 51.3% of the time. Results for faculty 50 years of age and older were comparable.


CONCLUSIONS
Improved pediatrician proficiency in the diagnosis and treatment of BI is needed for safe, cost-effective management. Physician age and experience appear to have a limited effect on the accuracy of BI diagnosis and management. Future educational efforts must be directed at trainees and their instructors.
School of Medicine, Johns Hopkins University, Baltimore, MD.
Daren J
DJ
Simkin
Division of Pediatric Dermatology, Department of Dermatology, Johns Hopkins University, Baltimore, MD.
Anna L
AL
Grossberg
Division of Pediatric Dermatology, Department of Dermatology, Johns Hopkins University, Baltimore, MD.
Bernard A
BA
Cohen
D002648:Child; D002983:Clinical Competence; D003880:Dermatology; D006801:Humans; D007169:Impetigo / Q000175:diagnosis*; D016712:Mupirocin; D011320:Primary Health Care; D012871:Skin Diseases
D016712:Mupirocin