Skin function parameters in intensive-care patients

Dermatological Problems in a Neurology Clinic

BACKGROUND

Little is known about the profile of dermatological problems in patients hospitalized in neurology wards or neurological intensive care units (NICUs). In this study, we aimed to provide the demographic and clinical characteristics of inpatients admitted to the neurology ward or the NICU.

METHODS

This study was designed as a retrospective observational study. Medical records of patients who consulted with dermatology while they were hospitalized in the neurology ward or the NICU of our hospital, from January 2016 to June 2022, were reviewed retrospectively. Demographic and clinical characteristics of the patients were recorded.

RESULTS

A total of 106 patients, including 86 patients in the ward and 20 patients in the NICU, were included in the study. Forty-nine patients (46.2%) were female and 57 (53.8%) were male. The mean age was 58.47±18.84 years. The frequency of dermatology consultations was 1% overall. The most common causes of hospitalization were ischemic stroke (n=47), demyelinating diseases of the central nervous system (n=10), and encephalitis (n=7). The most common dermatological problems in patients were infectious dermatoses (n=25), drug eruptions (n=18), and physical dermatoses (n=18). While drug eruptions were encountered as a common problem in the neurology ward, physical dermatoses were a common problem in the NICU.

CONCLUSION

The frequency of dermatology consultations requested from neurology for inpatients was low, especially in the NICU. Drug eruptions in the neurology ward and physical dermatoses in the NICU are encountered as common problems. Neurologists should pay attention to accompanying dermatological problems as well as neurological diseases. Large-scale prospective studies are needed for dermatological problems in patients hospitalized in the neurology clinic.

The effect of an acidic cleanser versus soap on the skin pH and micro-flora of adult patients: a non-randomised two group crossover study in an intensive care unit

OBJECTIVES

To test the effects of two different cleansing regimens on skin surface pH and micro-flora, in adult patients in the intensive care unit (ICU).

RESEARCH METHODOLOGY

Forty-three patients were recruited from a 23-bed tertiary medical/surgical ICU. The nineteen patients in Group One were washed using soap for daily hygiene care over a four week period. In Group 2, 24 patients were washing daily using an acidic liquid cleanser (pH 5.5) over a second four week period. Skin pH measurements and bacterial swabs were sampled daily from each for a maximum of ten days or until discharged from the ICU.

MAIN OUTCOME MEASURES

Skin surface pH and quantitative skin cultures (colony forming units).

FINDINGS

Skin pH measurements were lower in patients washed with pH 5.5 cleanser than those washed with soap. This was statistically significant for both the forearm (p = 0.0068) and leg (p = 0.0015). The bacterial count was not statistically significantly different between the two groups. Both groups demonstrated that bacterial counts were significantly affected by the length of stay in ICU (p = 0.0032).

CONCLUSION

This study demonstrated that the product used in routine skin care significantly affects the skin pH of ICU patients, but not the bacterial colonisation. Bacterial colonisation of the skin increases with length of stay.

Classification of dermatological disorders in critical care patients: a prospective observational study

PURPOSE

The objective of this study was to identify dermatological disorders detected in the intensive care unit (ICU), to analyze their specific characteristics, and to define a useful classification for intensive care physicians.

MATERIALS AND METHODS

This was a prospective, observational study over a 3-year period (2006-2009) in a mixed ICU. This included all patients presenting with dermatological disorders that were detected at the time of ICU admission or developed along the ICU stay. We recorded the specific characteristics of the disorders and its evolution and treatment, which enabled us to classify the different observed conditions. As general variables, we analyzed demographic factors, the principal diagnosis, ICU procedures, the severity score (Acute Physiology and Chronic Health Evaluation II), length of stay, and mortality.

RESULTS

One hundred thirty-three patients showed at least one dermatological disorder (9.3%) and were classified into (1) preexisting dermatological disorders, (2) life-threatening dermatologic disorders, (3) systemic dermatological disorders, (4) infectious dermatological disorders, (5) reactive dermatological disorders, and (6) others.

CONCLUSIONS

Dermatological disorders are a frequent problem in the ICU, and their recognition is key to set up an appropriate care plan. We propose a classification and description of the different types of dermatological disorders that are most commonly found in ICUs.