Dermatology in primary care: Prevalence and patient disposition

• Published in: Journal of the American Academy of Dermatology 2001-08, Vol.45 (2), p.250-255
• Main Authors: Lowell, Brooke A., Froelich, Catherine W., Federman, Daniel G., Kirsner, Robert S.
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Dermatology; Female; Humans; Male; Medical sciences; Primary Health Care - statistics & numerical data; Primary Health Care - utilization; Referral and Consultation; Retrospective Studies; Skin Diseases - diagnosis; Skin Diseases - therapy; Skin involvement in other diseases. Miscellaneous. General aspects
• ISSN: 0190-9622; 1097-6787
• DOI: 10.1067/mjd.2001.114598

Background: Cutaneous disease is commonly encountered in primary care. The frequency of patients presenting to primary care physicians with skin disease and their eventual disposition is not well studied. Objective: The purpose of this study was to determine the prevalence of patients seen with skin disease in a primary care setting and the likelihood of their referral to a dermatologist. The impact the primary care provider had on the quality of skin care was also examined. Methods: A retrospective chart review was performed of patients seen during a 2-year period at a general medicine clinic within the University of Miami and upon referral to a University of Miami dermatology office. Data were obtained on the prevalence of skin disease, dispositions of referral, diagnoses made, and procedures performed. Results: During a 2-year period, 36.5% of patients who presented to their primary care physician had at least one skin problem. Of 208 patients with skin disease, in 58.7% (122/208) it was their chief complaint. A wide range of diagnoses were made by the primary care physician, with a limited number of diagnostic procedures performed. Of the 37.5% of patients referred to a dermatologist, 68% were referred on initial evaluation. Diagnoses made by the primary care physician were concordant with that made by the dermatologists 57% of the time. Conclusion: Patients frequently see their primary care physician for skin disease. A large percentage are referred to dermatologists, often for a biopsy of a suspect lesion, to confirm a suspected diagnosis, or to establish a diagnosis of lesions of unknown origin. (J Am Acad Dermatol 2001;45:250-5.)