Dermatological Emergencies in a Tertiary Hospital: A Descriptive Study

Objective: This study aims to determine the frequency of adult patients presenting to the emergency department with skin lesions, and the main diagnoses made in the ED. We aimed to investigate the reasons of patients choose the emergency department rather than dermatology outpatient clinics in non-emergency situations.
Material and Method: This is a prospective study conducted on patients with dermatological conditions diagnosed in the emergency department of a tertiary hospital during a 6-month period. Basic epidemiological and clinical characteristics, and whether the situation is a "real emergency" from the perspectives of the patients and clinicians were recorded.
Results: A total of 262 patients were included. The three most common diagnoses in the ED were acute urticaria (41.6%), maculopapular drug eruptions (17.2%) and pruritus (7.6%). Dermatology consultation was requested for 26 (9.9%) of all patients. When evaluating the necessity of emergency ED examination from the point of view of the patient and the physician, and asked whether the situation was emergent, 74.0% of 262 patients reported that their condition was emergent, but the physicians evaluated only 40.0% of patients has a truly emergent situation. The most important factor in the choice of ED in non-emergent patients was the lack of medical insurance (20.6%).
Conclusion: Patients who presented to the ED with dermatological complaints were not always "true emergencies" and several factors may play a role preference of patients’ for the ED instead of the outpatient dermatology clinic. The most common cause was medical insurance problems according to our results.