Published: 2020-01-27

Study of cross-referrals to the dermatology department in an inpatient setting at a tertiary care centre

Niyati Bakhtar, Kirit Pandey, Neha Pandey, Nikhil Bakhtar, Vijay Bakhtar


Background: Till recently, dermatology was primarily being considered to be an outpatient focused discipline. However, several inpatient admissions to other specialties require dermatologic consultation for optimum management. This study was conducted to analyse the incidence and indications for inpatient dermatology referrals and the impact of dermatology consultation on patient management.

Methods: A cross-sectional study was undertaken by analyzing the records of 243 patients referred to dermatology department over a 2-year period. Descriptive analysis was conducted in the form of study of presumptive diagnoses by the referring clinicians, causes of referral, distribution of referrals across specialties and the dermatological opinions with respect to diagnosis and management etc.

Results: Clinically significant change was documented in the course of skin lesions management of almost two-thirds of referred patients. Maximum referrals were from the department of general medicine with “skin rash” being the most common cause for seeking 2nd opinion. Concordance for diagnosis between the referring clinician and the dermatologist was observed in only 30.2% of the cases.

Conclusions: Dermatologic referral does lead to improved patient care. But there is need for better training of non-dermatologists enabling them to recognize and treat common skin lesions.


Cross-referrals, Dermatology, In-patient, Tertiary care

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Penate Y, Guillermo N, Melwani P, Martel R, Borrego L. Dermatologists in hospital wards: an 8-year study of dermatology consultations. Dermatol. 2009;219(3):225-31.

Kirsner RS, Yang DG, Kerdel FA. The changing status of inpatient dermatology at American academic dermatology programs. J Am Acad Dermatol. 1999 May 1;40(5):755-7.

Maza A, Berbis J, Gaudy-Marqueste C, Morand JJ, Berbis P, Grob JJ, et al. Evaluation of dermatology consultations in a prospective multicenter study involving a French teaching hospital. Annal Dermatol Venereol. 2009;136(3):241-8.

Fernandes IC, Velho G, Selores M. Dermatology inpatient consultation in a Portuguese university hospital. Dermatol Online J. 2012 Jun 1;18(6).

Walia NS, Deb S. Dermatology referrals in the hospital setting. Ind J Dermatol, Venereol, Leprol. 2004 Sep 1;70(5):285.

Lorente-Lavirgen AI, Bernabeu-Wittel J, Pulpillo-Ruiz A, de la Torre-García JM, Conejo-Mir J. Inpatient dermatology consultation in a Spanish tertiary care hospital: a prospective cohort study. Actas Dermo-Sifiliográficas. 2013;104(2):148-55.

Mancusi S, Festa Neto C. Inpatient dermatological consultations in a university hospital. Clin. 2010;65(9):851-5.

Davila M, Christenson LJ, Sontheimer RD. Epidemiology and outcomes of dermatology in-patient consultations in a Midwestern US university hospital. Dermatol Online J. 2010 Feb 1;16(2).

Chandalavada M. Study of inpatient dermatologic referrals. Abstract: 12th South Zone Confe o IADVL; Oct 2012:102.

Falanga V, Schachner LA, Rae V, Ceballos PI, Gonzalez A, Liang G, et al. Dermatologic consultations in the hospital setting. Archiv Dermatol. 1994 Aug 1;130(8):1022-5.

Jessop S, McKenzie R, Milne J, Rapp S, Sobey G. Pattern of admissions to a tertiary der matology unit in South Africa. Int J Dermatol. 2002 Sep;41(9):568-70.

Ahmad K, Ramsay B. Analysis of inpatient dermatologic referrals: insight into the educational needs of trainee doctors. Irish J Med Sci. 2009 Mar 1;178(1):69-71.

Walia NS, Deb S. Dermatology referrals in the hospital setting. Ind J Dermatol, Venereol, Leprol. 2004 Sep 1;70(5):285.