Skin Findings in Palliative Care Patients

Dermatological Diseases in Palliative Care Patients in a University Hospital: A Prospective Study

OBJECTIVE

Patients receiving palliative care are more prone to dermatological disease. The aim of our study was to determine the frequency of dermatological diseases and associated factors in patients receiving palliative care support.

METHODS

This prospective observational study included inpatients in the palliative care unit of our university hospital in Erzurum/TURKEY. The patients were evaluated by the same dermatologist within the first 48 h of admission and 3 days a week during follow-up. Demographic data, reasons for admission to the palliative care unit, and skin lesions at the time of admission and during follow-up were recorded.

RESULTS

The median age of the 259 patients included in the study was 77.0 years (min- max, 19-108) and 54.4% were women. Dermatological disease was detected in 246 patients (96.1%) at admission to the palliative care unit and in 185 patients (71.4%) patients during follow-up. The most common dermatological disease at admission was dry skin (n  =  175, 67.6%), which was also the most common cause of pruritis (n  =  29, 11.2%). The most common skin infection was dermatophytosis (n  =  57, 22.0%) and the most common type of dermatitis was contact dermatitis (n  =  17, 6.6%). Nearly all tumors were benign (n  =  32, 12.4%) and most chronic wounds were pressure ulcers (n  =  96, 37.1%). During hospital follow-up, the most frequent dermatitis was contact dermatitis (n  =  44, 17.0%), the most frequent skin infection was candidiasis (n  =  25, 9.7%), the most common chronic wound was pressure ulcers (n  =  25, 9.7%), the most common dermatological disease was urticaria (n  =  14, 5.4%), and all cases of pruritus were associated with dry skin (n  =  8, 3.1%).

CONCLUSIONS

The frequency of dermatological findings is high among patients receiving palliative care. Therefore, dermatologists should be included in multidisciplinary palliative care teams and evaluate palliative care patients early and regularly.

Beyond striae cutis: A case report on how physical skin complaints unveiled end-of-life total experience

BACKGROUND

End-of-life is a unique and multidimensional experience, and physical complaints can reveal other areas of distress.

METHOD

A case report of a woman with terminal cancer with painful and deforming skin striae cared by a multidisciplinary team.

RESULTS

After initially treating her physical pain, other end-of-life psychosocial, spiritual, and existential aspects could be addressed.

SIGNIFICANCE OF RESULTS

Physical distress can unveil other essential areas of end-of-life experience when multidisciplinary teams caring for the terminally ill patients use holistic approaches.

Dermatological diseases in palliative care patients: a prospective study of 271 patients

BACKGROUND

Numerous risk factors place palliative care patients at an increased risk of skin infections, dermatitis, and pressure sores. Furthermore, worsening of chronic skin disorders can be expected, as well as the development of treatment-induced and malignancy-related dermatoses. The objective of the present study was to investigate the prevalence and treatment of dermatological conditions in patients receiving hospital-based palliative care.

METHODS

Two hundred seventy-one palliative patients were enrolled. All assessments were conducted by dermatologists. Skin lesions were classified into seven categories: infections, skin tumors, dermatitis, chronic wounds, nail and hair disorders, pruritus, and other unclassified conditions. Treatment modalities were classified as topical only or systemic.

RESULTS

Overall, 1,267 dermatological conditions were recorded, 49 % of which were hospital-acquired. All patients had at least one dermatological condition, and more than 50 different dermatological disorders were noted. The most common group of skin disorders was dermatitis (18.3 % of all dermatological conditions), followed by nail and hair disorders (17.5 %). Almost 16 % of dermatological conditions were treated systemically.

CONCLUSIONS

Dermatological conditions are a common and clinically significant problem for palliative patients. The inclusion of dermatologists in multidisciplinary palliative teams should prove helpful in the management of these patients.