15 Things Dermatologists Think Hospitalists Need to Know

The Hospitalist. 2013 May;2013(05):

May 1, 2013 | The Hospitalist

“The clinical picture of warm, red, tender skin can fit many conditions but is most often called cellulitis by nondermatologists. It’s not clear why, but I would suspect this is because cellulitis is one of the few dermatologic conditions taught in medical school, while the mimickers get less attention.”

—Daniela Kroshinsky, MD, MPH, director of inpatient dermatology, education, and research, Massachusetts General Hospital, Boston

Encourage patients to follow up with a dermatologist on an outpatient basis.

By heeding this advice, patients are less likely to return to the ED for skin conditions that can be managed in an office, says Kirsten Flynn, MD, a dermatologist at Banner Health Center in Sun City West, Ariz. Inpatient admissions by dermatologists have been decreasing over the years. Most patients with skin diseases or cutaneous manifestations of systemic illnesses are admitted to hospitals by other physicians.

“Many dermatologists are happy to fit in urgent consults in their clinics. Drug eruptions are by far the most common consultation request,” says Dr. Flynn, who notes that high-dose IV steroids can cause complications, such as gastrointestinal bleeding, bowel perforation, opportunistic infections, and exacerbation of underlying diseases. “In most cases, removing the offending agent and providing supportive care is the best option.”

Susan Kreimer is a freelance writer in New York.