Emergency department utilization of pediatric dermatology (PD) consultations

Background: There are few published data about pediatric dermatology (PD) consultations in the pediatric emergency department (PED). Objective: We profiled PD consultations to determine patterns of dermatology utilization by the PED. Methods: We reviewed electronic medical records of 347 PD consultations from the PED over a 36-month period from January 2011 to December 2013. We recorded patient age and gender; PED diagnosis; PD diagnosis; skin biopsy, if needed, with histopathology report; and outpatient PD follow-up. Results: Patient age ranged from 3 days to 18 years with the majority (54.8%) of consultations for patients aged 0 days to 5 years. The most common diagnostic categories were infections and inflammatory skin disorders. Atopic dermatitis was the most common individual diagnosis. In all, 48.1% of patients had PD outpatient clinic follow-up. The rate of diagnostic agreement between the pediatric emergency medicine and PD provider was 58%. Limitations: Use of electronic medical records, retrospective study design, and population based at a tertiary-care children's hospital represent potential limitations. Conclusions: PD providers contribute to patient care in the PED. Dermatology education in the PED should include the more commonly encountered disorders identified in this study, including infectious diseases and atopic dermatitis.