Pattern of dermatology referrals in a tertiary care center in North East India

Abstract

Background: Dermatologists besides providing service to patients in the outdoors, also play a vital role in the care of inpatients admitted to dermatology unit and other departments. The aim of the study was to evaluate the pattern of referrals sent to the dermatology department by other departments. Methods: A retrospective study was carried out on 487 patient referrals requested to department of dermatology, of Regional institute of Medical Sciences, Imphal, Manipur for a period of 5 years from January 2005 to December 2010. The department maintains a consultation register where the demographic details, specialty requiring dermatological consultation, time frame between admission and referral request and diagnosis, investigation and treatment of the patients were entered. Patients were evaluated within few hours from the time of consultation. Procedures such as skin biopsy, fungal culture or KOH smears etc. were performed wherever required. All these information’s entered in referral register were collected from register. All the patients entered in register from January 2005 to December 2010 were selected and none were excluded. Ethical approval was obtained from research ethics board. Data were entered in IBM SPSS statistics 21 for Windows (IBM Corp. 1995, 2012). Descriptive statistics such as frequency, percentages, mean with standard deviation and median were used. Analysis was done using Chi-square test to check the significance between proportion and p value<0.05 was taken as statistically significant. Results: A total of 487 consultations were recorded. Most (48.3%) consultations were received from general medicine, followed by surgery (14.4%), gynecology (9.4%), chest medicine (5.54%) with the least from PMR (1.23%) and psychiatry (1.84%). Infectious skin diseases were most common (37.5%) followed by eczema (22.3%) and drug reactions (11%). Among infections viral infections topped the list (Herpes simplex- 35.9%), among eczema chronic eczematous dermatitis (22.9%). Among drug reaction severe cutaneous adverse drug reaction was present in 12 cases. Conclusions: Dermatology referrals can enhance the dermatological knowledge of non-dermatologists to diagnose and manage common dermatoses thus improving overall patient care.