Characteristics of Pediatric Visits to the Emergency Department With Dermatological Complaints.

OBJECTIVES

Dermatological diseases constitute 4% to 12% of all emergency department (ED) visits and may contribute to high health care costs. However, little is known about pediatric visits. The aim of this study was to determine characteristics, photo app utilization, and diagnostic concordance at follow-up of pediatric visits to the ED with dermatological complaints.

METHODS

This was a retrospective study conducted in the ED at an academic medical center. Patients younger than or equal to 18 years of age who presented with a dermatologic concern between May 2022 and April 2023 were included. The association between clinical characteristics and the use of a photo application in the ED was evaluated using logistic regression.

RESULTS

In 380 patients who met inclusion criteria, the most common final diagnoses were rash (30%, N=115), burn (10%, N=39), and cellulitis (9%, N=35). Fourteen patients (4%) had an emergent triage category (ESI 2). Photo app was used in 38% (N=143) encounters. Factors associated with the photo app use in multivariate analysis included ESI category 2 (odds ratio [OR]: 4.08, 95% CI: 1.17-14.18, P =0.027), ESI category 3 (OR: 1.74, 95% CI: 1.07-2.82, P =0.025), and duration of illness >1 week (OR: 3.50, 95% CI: 1.54-7.96, P =0.003). The diagnosis at follow-up was identical in 68% (N=78) of cases; clarified for 22% (N=25) and altered in 11 patients (10%).

CONCLUSIONS

Most pediatric visits presenting to the ED with dermatological complaints are non-urgent and ER physicians can accurately diagnose the majority of these cases. Triage category ESI 2, ESI 3, and illness duration >1 week were associated with the photo app use.