The effect of the COVID-19 pandemic on dermatology consultation requests from adult and paediatric emergency departments

Comparative Evaluation of Dermatological Emergency Consultations in the Coronavirus Pandemic Era: Tertiary Clinic Experience

INTRODUCTION

Due to the increase in COVID-19 patients during the pandemic, the workload of emergency departments has increased. The profile of patients seeking non-COVID medical care has changed significantly because of the pandemic; this includes dermatological emergencies.

OBJECTIVE

The aim was to evaluate and compare adult dermatological emergency consultations during the COVID-19 period with the pre-pandemic period.

METHODS

Consulted patients from ED to dermatology between March 11, 2019, and March 11, 2021 were included (Pre-pandemic and pandemic). Age, gender, zone of triage, consultation hour, consultation date, consultation response time, ICD-10 codes were recorded.

RESULTS

The total number of consultations was 639. The mean age of the patients was 44.4 in the pre-pandemic period and 46.1 in the pandemic period. The mean consultation response time was 44.4 minutes in the pre-pandemic period and 60.3 minutes in the pandemic. In the pre-pandemic period, the most common consulted diseases were herpes zoster, urticaria, and allergic contact dermatitis. During the pandemic, the most common consulted diseases were herpes zoster, other dermatitis, and urticaria. There was a statistically significant difference in the incidence of other dermatitis, impetigo/folliculitis, cutaneous vasculitis, and pruritus (p<0.05) CONCLUSIONS: Emergency departments are the busiest and fastest areas of the hospital. Pandemics such as COVID-19 may also occur in the coming years. Informing society about dermatological emergencies and adding adequate dermatology training to the training of emergency physicians will facilitate appropriate patient management in emergency departments.

The Impact of COVID-19 on Hyperhidrosis Patients in the Mental Health and Quality of Life: A Web-Based Surveillance Study

Background: We aimed to investigate the impact of the COVID-19 pandemic on the degree of depression among hyperhidrosis patients and their quality of life. Methods: 222 patients were contacted through an online questionnaire. Patients reported quality of life (QoL), including treatment and changes in symptoms during the pandemic, and also responded to the Patient Health Questionnaire-9 (PHQ-9) to evaluate the severity of depression. Those were compared with the result from the general population. Spearman correlation and multiple linear regression were performed to identify the factors related to the PHQ-9 score. Results: Half of the patients were female. The mean PHQ-9 score (5.25) of hyperhidrosis patients was higher than the general population, and female patients displayed significantly higher PHQ-9 scores than males (p = 0.002). QoL was impaired more in females. About 10% of patients experienced worsening symptoms, and 30% had difficulties getting appropriate management. Significant negative correlations were found between the PHQ-9 and age or disease duration. Predictive factors for the PHQ-9 were female (p = 0.006) and facial hyperhidrosis (p = 0.024). Conclusions: The level of depression among hyperhidrosis patients was higher than the general population during the COVID-19 pandemic; female and facial hyperhidrosis patients need much more psychiatric attention. Though hyperhidrosis is classified as benign and often neglected by clinicians, we need to give more awareness to the mental burden imposed by the COVID-19 pandemic.

The effect of the COVID-19 pandemic on dermatology consultation requests from adult and paediatric emergency departments

AIM

This study aimed to determine the characteristics of dermatology consultation requests from the adult and paediatric emergency departments (EDs) of a university hospital during 8 months of the COVID-19 pandemic in 2020 and to compare them with the same 8 months of 2019.

MATERIALS AND METHODS

Electronic medical records of dermatology consultation requests from adult and paediatric EDs between 15 March 2019 and 15 November 2019, and between 15 March 2020 and 15 November 2020 were retrospectively reviewed.

RESULTS

The study included 495 consecutive dermatology consultation requests. In total, 283 (57%) consultation requests occurred in 2019, vs 212 (43%) between in 2020 during the COVID-19 pandemic. The number of consultation requests per day was significantly lower in 2020 (0.9 ± 0.1 per day) than in 2019 (1.15 ± 0.1 per day; P = .002), and was significantly lower in March, April and May 2020, as compared with March, April, and May 2019 (P = .004, P = .001, and P = .001, respectively). The median time from onset of dermatological symptoms to ED presentation was significantly longer in 2020 than in 2019 (4 days in 2019 vs 7 days in 2020; P < .001). Dermatological emergencies in 2019 and 2020 constituted 6.7% of all emergency presentations, with no significant difference between the 2 years (7.1% of all ED presentations in 2019, vs 6.1% in 2020; P = .795).

CONCLUSION

COVID-19 restrictions and fear of COVID-19 infection might have discouraged patients from presenting to EDs because of skin problems; however, the easing of COVID-19 restrictions might lead to an increase in ED presentations, including non-urgent dermatological disorders. In order to reduce unnecessary use of EDs and prevent ED overcrowding, the general public should be educated about what constitutes a dermatological emergency.