PREVALENCE OF CUTANEOUS FINDINGS IN HOSPITALIZED PEDIATRIC-PATIENTS

Cutaneous findings can be useful in establishing the diagnosis and tre atment of hospitalized patients. Observation and identification of cut aneous abnormalities can improve the accuracy of diagnosis and result in improved patient care. We set out to determine the prevalence of cu taneous abnormalities in hospitalized pediatric patients in a hospital and how often these findings were noted and properly diagnosed by the admitting team of physicians. Children with medical problems admitted to Kosair Children's Hospital during the month of January 1995 were r andomly selected for a skin examination, which was performed within 24 to 28 hours of admission. Parental consent was required prior to admi ssion into the study. Of 117 patients offered participation, 110 accep ted. Physical findings were noted and in addition the completeness of charting by the admitting physician and the relationship of any cutane ous findings to admitting diagnosis were noted. One hundred five of th e 110 patients (95%) had cutaneous findings consisting of either a ''r ash'' or a ''congenital lesion.'' Fifty-one had more than one cutaneou s finding noted on examination. Dermatitis was the most common diagnos is made, followed by pigmented lesions and congenital vascular malform ations of all types. In 35 of the 105 patients with a dermatologic dia gnosis, the dermatologic diagnosis related directly to the admitting d iagnosis. In only 22 of these 35 (63%) was the cutaneous involvement n oted by the admitting physician. In 9 of the 110 cases (8%), the findi ngs on dermatologic examination altered the primary diagnosis and/or t reatment. Cutaneous findings are very common in the hospitalized pedia tric patient. The diagnosis, charting, and treatment of dermatologic c onditions by the primary pediatric team were often incomplete, althoug h an expert cutaneous examination can be critical to patient care.