Analysis of Dermatologic Consultations in Neuropsychiatric Inpatients / 대한피부과학회지

BACKGROUND: Many patients seeking treatment for skin disorders have an underlying psychiatric problem that either causes or exacerbates a skin condition; thus, the demand for dermatologists' expert opinions on such cases is increasing. OBJECTIVE: The purpose of this study was to analyze and quantify the pattern of dermatologic consultations referred by the department of neuropsychiatry in a tertiary hospital. METHODS: We retrospectively studied data from 337 inpatients referred by the department of neuropsychiatry for dermatologic consultation during an 8.5-year period in a tertiary hospital. RESULTS: The percentage of department of neuropsychiatry patients who were referred to the department of dermatology for consultation was 15.3%. The most prevalent age group for referrals was 30~39 years (26.4%), and the male-to-female ratio was 1:1.6. Bipolar disorder was the most common underlying neuropsychiatric problem (31.1%), and eczema (36.5%) was the most common dermatoses, followed by infectious disease (27.6%). The main reasons for dermatologic consultations were dermatologic disease (71.5%) and treatment-related dermatoses (10.1%). Thirty-five cases were discordant as to the reason for consultation between psychiatrists and dermatologists. Neuropsychiatric medication-related adverse reactions were reported in 9.8% of referred patients. CONCLUSION: This study revealed the distribution of skin disorders in patients referred by department of neuropsychiatry for dermatologic consultation. We believe its findings could be helpful as educational material to encourage cooperation between the specialties of dermatology and neuropsychiatry.

Clinical Evaluation of Dermatologic Consultations in Psychiatric Inpatients / 대한피부과학회지

BACKGROUND: The need for dermatological consultations for hospitalized patients has gradually increased and there are a number of dermatoses caused by underlying psychological conditions. However, the data regarding the analyses of these consultations for psychiatric inpatients are limited. OBJECTIVE: To analyze the demographics and the type of dermatoses among inpatients with primary psychiatric diseases. METHODS: We retrospectively reviewed 581 consultation reports for inpatients referred by the Department of Psychiatry between January 1, 2009 and December 31, 2014. RESULTS: The proportion of the consulted patients from the Department of Psychiatry was 25.9% (331 consulted inpatients/1279 psychiatric inpatients). The most common age group was the 40~49 year-old group (19.3%) and the male to female ratio was 1:1.14. There were no remarkable findings regarding the annual or seasonal distribution. According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), the most common underlying psychiatric disorders were mood disorders (41.0%), followed by schizophrenia and other psychotic disorders (25.0%), and substance-related disorders (12.1%). The most frequent skin disorders were eczematous dermatoses (34.6%) and infectious dermatoses (32.2%); dermatomycosis (20.8%) was especially common. The most common reasons for consultation were new-onset dermatologic problems (68.5%), followed by persistence or aggravation of pre-existing dermatologic disorders (28.7%). CONCLUSION: This study reports the dermatologic characteristics of psychiatric inpatients. We conclude that dermatologists and psychiatrists need to be concerned about the education and continuous management of various skin diseases in psychiatric patients.

Review of Psychiatric Adolescent Inpatient with Dermatologic Consultations / 정신신체의학

OBJECTIVES: To review the patterns of the dermatologic consultations of psychiatric adolescent inpatient and to explore the relationship between the dermatologic disorders and psychiatric disorders. METHODS: We retrospectively studied the data from 22 cases referred by psychiatric adolescent for a dermatologic consultation over 10 years in Daegu Catholic University Medical Center and compared with the data from 108 cases referred by the other department adolescent patients. RESULTS: The mean age of patients was 15.9. The male to female ratio was 1:1.44. The most common psychiatric and dermatologic disorder was major depressive disorder and acne, respectively. The most frequent reason for consultation was to ask for dermatologic disease or condition(54.5%) followed by to perform cosmetic procedure of patients need(40.9%) and to perform dermatologic test(4.6%). CONCLUSIONS: More than just a cosmetic disfigurement, dermatologic disorders are associated with a variety of psychopathologic problems that can affect the patient. Increased understanding of biopsychosocial approaches and liaison among psychiatrists and dermatologists could be beneficial.

A Statistical Analysis and Clinical Evaluation of Dermatologic Consultations in Obstetrics and Gynecologic Inpatients / 대한피부과학회지

BACKGROUND: Dermatologic comorbidities can be the clue for the diagnosis and treatment of systemic conditions and a need for dermatological expert opinion is increased. OBJECTIVE: To analyze the patterns and to quantify the dermatologic consultations referred by the department of obstetrics and gynecology (OBGY). METHODS: We retrospectively studied the data from 479 cases referred by OBGY for a dermatologic consultation during a three-year period in a tertiary hospital. RESULTS: The most common skin disorder was pregnancy-related dermatoses (29.77%) in obstetric inpatients, while cutaneous infection (33.33%) was the most frequent in gynecologic inpatients. The distribution of the skin disorders in consulted OBGY inpatients was consistent with the previous reports. However, there were some differences, such as high proportion of infectious disease. Infectious skin diseases were significantly more frequent (p<0.001) in the chemotherapy group of gynecologic inpatients compared to that of the non-chemotherapy group, viral infection being the most common. In addition, superficial fungal infection accounted for the same proportion as the viral infection (37.50% each) among obstetrical inpatients. Maculopapular or urticarial eruption (51.52%) was the most common type of chemotherapy-related adverse drug reaction. CONCLUSION: This study revealed the distribution of skin disorders in patients referred by OBGY for dermatologic consultation. Furthermore, it could be helpful as an educational material to assist cooperation between dermatology and OBGY.

Analysis of Dermatologic Consultations in Intensive Care Unit Patients / 대한피부과학회지

BACKGROUND: Due to the characteristics of the intensive care unit (ICU), with its focus on patient's vital functions, dermatological symptoms are frequently overlooked during admission. But, there are occasions when a dermatological opinion in the ICU can be of value. OBJECTIVE: The purposes of this study were to analyze the frequency and characteristics of dermatologic consultations in patients admitted to ICUs and also to compare the results to other reports regarding inpatient dermatologic consultation. METHODS: We analyzed the data of 437 ICU patients who were consulted at a Department of Dermatology between January 1, 2007 and December 31, 2010. The total number of male and female patients were 241 (55.1%) and 196 (44.9%) (M : F = 1.23 : 1). We retrospectively reviewed medical records and demographics, reason of dermatologic consultation and the diagnosis of the dermatoses. RESULTS: The percent of patients who were referred to the Department of Dermatology for consultation was 1.9%. The most frequent age group was the 7th decade of life and the highest incidence of seasonal distribution was summer. Patients admitted to the Department of Internal Medicine were the most frequently consulted group. The most common underlying disease was pulmonary disorders. The most common skin disorders were infectious diseases (28.8%), followed by eczema (15.8%) and drug eruption (11.4%). The main reasons for dermatologic consultations were dermatologic diseases or conditions (53.7%), skin lesions related to the treatment of underlying diseases (26.3%), skin lesions of systemic diseases (10.0%) and the dermatologic tests (6.1%). CONCLUSION: The characteristics of dermatologic consultation in the ICU may be quite different from those of inpatient dermatologic consultation. Collaboration between the intensive care physician and dermatologist can improve the quality of patient care in the ICU.

Analysis of Dermatologic Consultations in Rheumatologic Inpatients / 대한피부과학회지

BACKGROUND: Many different dermatologic manifestations can accompany a variety of systemic diseases such as rheumatic disorders. The number of patients who have skin lesions related to systemic diseases is steadily increasing. In such cases, dermatologic consultation can be important to diagnosis and treatment. OBJECTIVE: The purpose of this study was to analyze patterns of skin manifestations in rheumatic diseases. METHODS: We did an analysis of data for 192 inpatients who were referred by the department of rheumatology and consulted by the department of dermatology between May 1, 2005 and April 30, 2009. We retrospectively reviewed their medical records and noted age, sex, reasons for dermatologic consultation, diagnosis of the dermatoses and changed diagnosis after the consultation. RESULTS: The percent of patients who were referred by the department of rheumatology and consulted by the department of dermatology was 15.5% (192 consulted inpatients/1,242 rheumatologic inpatients). The most frequent age group was those in their 5th decade of life (23.0%) and the male to female ratio was 1:2.15. Consultations for dermatologic manifestations unrelated to systemic or rheumatic diseases were the most common reason for consultation (62.0%). Dermatoses related to systemic or rheumatic diseases were the 2nd most common reason of consultation (34.9%). Infectious diseases were the most common dermatoses (46 cases). There were 13 cases where there was a diagnosis of undetermined dermatoses and changed diagnosis after dermatologic consultation. CONCLUSION: Analysis of consultations from inpatients referred by the department of rheumatology to the department of dermatology indicates that there is a substantial number of patients that have skin manifestations of their rheumatic diseases.

A comparative study on clinical evaluation of inpatient dermatology consultation between 1976 and 1991 / 대한피부과학회지

424 patients who were consulted to department of dermatology during their admission in Ewha Womans University Hospital from Jan.to Dec. 1991 were analyzed in order to evaluate the tendency of dermatologic problems. The results were as follows: 1. The most frequent dermatologic problem was eczema. 2. Age prevalence was highest between 40-49. 3. The most frequent dermatologic problem was found in spring. 4. The pathents in internal rnedicine were most, frequently consuled. 5. Patients with diabetes mellitus were most frequently consulted among systernic disease. 6. There was no significant difference in sex ratio. 7. The rate of consultation for acne was increased compared to 1976. 8. The rate of cosultatin for fungal infection was increased compared to the frequency rate of fungal infection of new patients at OPD in 1991.