Outpatient dermatology consultation impacts the diagnosis and management of pediatric oncology patients: A retrospective study

J Am Acad Dermatol. 2017 Nov;77(5):879-885. doi: 10.1016/j.jaad.2017.06.005. Epub 2017 Jul 18.

Abstract

Background: The impact of dermatology consultation on the care of children with oncologic conditions is unknown.

Objective: To review outpatient dermatology visits and the resulting impact on diagnosis and management of pediatric oncology patients.

Method: Retrospective review of pediatric oncology patients with outpatient dermatology visits at a tertiary care center from 2008 to 2015.

Results: The most common dermatologic diagnoses in 516 patients were skin infections (21.3%) and nonmalignant skin eruptions (33.4%). A diagnosis of significant impact (ie, malignancy, adverse cutaneous drug reaction, graft-versus-host disease, varicella-zoster virus, or herpes simplex virus infection), was made at the dermatology clinic in 14.7% of visits. Consultation resulted in a change in diagnosis in 59.8% of patients, change in dermatologic management in 72.4% of patients, and change in management of noncutaneous issues in 12.4% of patients.

Limitations: The use of electronic medical records, the nongeneralizable study population, and the retrospective design represent potential limitations.

Conclusion: Outpatient dermatology consultation can affect the care of pediatric oncology patients with respect to diagnosis and treatment of skin conditions and management of nondermatologic issues.

Keywords: epidemiology; management; outpatient visits; pediatric oncology; treatment.

MeSH terms

  • Adolescent
  • Ambulatory Care / methods
  • Child
  • Child, Preschool
  • Databases, Factual
  • Dermatology
  • Disease Management
  • Female
  • Graft vs Host Disease / diagnosis
  • Graft vs Host Disease / epidemiology
  • Hospitals, Pediatric
  • Humans
  • Infant
  • Male
  • Neoplasms / diagnosis*
  • Neoplasms / therapy
  • Outpatients / statistics & numerical data*
  • Pediatrics
  • Prognosis
  • Quality Improvement*
  • Referral and Consultation / statistics & numerical data*
  • Retrospective Studies
  • Risk Assessment
  • Skin Diseases, Infectious / diagnosis*
  • Skin Diseases, Infectious / epidemiology
  • Tertiary Care Centers
  • Treatment Outcome