Ann Dermatol.  2016 Jun;28(3):314-320. 10.5021/ad.2016.28.3.314.

Analysis of Dermatologic Diseases in Neurosurgical In-Patients: A Retrospective Study of 463 Cases

Affiliations
  • 1Department of Dermatology, College of Medicine, The Catholic University of Korea, Seoul, Korea. drchos@yahoo.co.kr
  • 2Department of Pediatrics, Dankook University Medical College, Cheonan, Korea.
  • 3Department of Neurosurgery, College of Medicine, The Catholic University of Korea, Seoul, Korea. kjtns@olmh.cuk.ac.kr

Abstract

BACKGROUND
Both the skin and the neurologic system are derived from the ectoderm during embryogenesis, and thus patients with neurologic disorders may have accompanying dermatologic diseases. For example, seborrheic dermatitis is more frequently observed in patients with Parkinsonism and other neurologic disorders. To date, however, there has been limited review on dermatologic diseases in neurosurgical in-patients.
OBJECTIVE
The purpose of this study was to characterize dermatological problems encountered in a neurosurgery unit and to compare these data to previous reports of in-patient dermatologic consultations.
METHODS
A retrospective review was conducted over all in-patient dermatology consultations from the neurosurgery unit during a 3-year period.
RESULTS
Of 2,770 dermatology consultations, 463 (16.7%) came from the department of neurosurgery. The most frequent age group was the 6th decade of life, and the ratio of men to women was 1.07. Consults were most frequently placed from patients with intracranial hemorrhage (23.8%). Eczema/dermatitis (36.5%; n=204) and cutaneous infections (27.0%; n=151) accounted for more than half of all dermatological consultations, followed by cutaneous adverse drug reactions (11.8%; n=66). Additionally, seborrheic dermatitis was significantly more frequent (p=0.048, odds ratio=1.96) in patients with intracranial hemorrhage.
CONCLUSION
This study characterizes the distribution of skin disorders in patients admitted to the neurosurgery service based on the consultations that have been made for dermatologic evaluation. Collaboration between the neurosurgeons and dermatologists may improve the quality of patient care and help to better predict the occurrence of these conditions.

Keyword

Dermatology; Neurosurgery; Referral and consultation

MeSH Terms

Cooperative Behavior
Dermatitis, Seborrheic
Dermatology
Drug-Related Side Effects and Adverse Reactions
Ectoderm
Embryonic Development
Female
Humans
Intracranial Hemorrhages
Male
Nervous System Diseases
Neurosurgeons
Neurosurgery
Parkinsonian Disorders
Patient Care
Pregnancy
Referral and Consultation
Retrospective Studies*
Skin

Reference

1. Choi MR, Park HS, Byun HJ, Cho KH. Clinical evaluation of dermatology consultation in inpatients. Korean J Dermatol. 2010; 48:163–170.
2. Kim MJ, Cho SY, Whang KK, Hahm JH. A statistical analysis of dermatologic consultation in nondermatologic inpatients. Korean J Dermatol. 2000; 38:1007–1015.
3. Marcus EL, Fischer M. Analysis of dermatologic consultations in a general hospital. J Dtsch Dermatol Ges. 2013; 11:181–184.
Article
4. Peñate Y, Guillermo N, Melwani P, Martel R, Borrego L. Dermatologists in hospital wards: an 8-year study of dermatology consultations. Dermatology. 2009; 219:225–231.
Article
5. Lyu SM, Byun JY, Choi YW, Choi HY. Clinical features of dermatology-consulted inpatients: focus on the differences between individual departments. Korean J Dermatol. 2014; 52:215–221.
6. Noh TK, Haw S, Won CH, Chang SE, Lee MW, Choi JH, et al. A statistical analysis and clinical evaluation of dermatologic consultations in obstetrics and gynecologic inpatients. Korean J Dermatol. 2012; 50:951–958.
7. Won JH, Park JS, Chung H, Jang HC. Analysis of dermatologic consultations in rheumatologic inpatients. Korean J Dermatol. 2009; 47:891–895.
8. McMahon P, Goddard D, Frieden IJ. Pediatric dermatology inpatient consultations: a retrospective study of 427 cases. J Am Acad Dermatol. 2013; 68:926–931.
Article
9. Koh H. A retrospective analysis of dermatological problems in a hematology ward. Clin Cosmet Investig Dermatol. 2013; 6:145–149.
Article
10. Lee HS, Yoo DJ, Park HW, Yang DH, Myung SJ, Yang SK, et al. Is a stricter colonoscopy screening protocol necessary in liver transplant recipients? Comparison with an average-risk population. Dis Colon Rectum. 2014; 57:976–982.
Article
11. Aberdam D, Gambaro K, Medawar A, Aberdam E, Rostagno P, de la Forest Divonne S, et al. Embryonic stem cells as a cellular model for neuroectodermal commitment and skin formation. C R Biol. 2007; 330:479–484.
Article
12. Rubin-Asher D, Zeilig G, Klieger M, Adunsky A, Weingarden H. Dermatological findings following acute traumatic spinal cord injury. Spinal Cord. 2005; 43:175–178.
Article
13. Mastrolonardo M, Diaferio A, Logroscino G. Seborrheic dermatitis, increased sebum excretion, and Parkinson's disease: a survey of (im)possible links. Med Hypotheses. 2003; 60:907–911.
Article
14. Tay LK, Lee HY, Thirumoorthy T, Pang SM. Dermatology referrals in an East Asian tertiary hospital: a need for inpatient medical dermatology. Clin Exp Dermatol. 2011; 36:129–134.
Article
15. Chren MM. Dermatologic consultations--how can we know if we are effective? Initial methodologic considerations for the critical assessment of medical interventions performed by physicians. Arch Dermatol. 1994; 130:1052–1054.
Article
16. Fischer M, Bergert H, Marsch WC. The dermatologic consultation. Hautarzt. 2004; 55:543–548.
17. Collins CD, Hivnor CM. Seborrheic dermatitis. In : Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, Leffell DJ, Wolff K, editors. Fitzpatrick's dermatology in general medicine. 8th ed. New York: McGraw-Hill;2012. p. 259.
18. Reed WB, Pidgeon J, Becker SW. Patients with spinal cord injury. Clinical cutaneous studies. Arch Dermatol. 1961; 83:379–385.
19. Wilson CL, Walshe M. Incidence of seborrhoeic dermatitis in spinal injury patients. Br J Dermatol. 1988; 119:48.
Article
20. Chen TM, Fitzpatrick JE. Unilateral seborrheic dermatitis after decompression of Chiari I malformation and syringomyelia. J Am Acad Dermatol. 2006; 55:356–357.
Article
21. van Asch CJ, Luitse MJ, Rinkel GJ, van der Tweel I, Algra A, Klijn CJ. Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: a systematic review and meta-analysis. Lancet Neurol. 2010; 9:167–176.
Article
22. Lovelock CE, Molyneux AJ, Rothwell PM. Oxford Vascular Study. Change in incidence and aetiology of intracerebral haemorrhage in Oxfordshire, UK, between 1981 and 2006: a population-based study. Lancet Neurol. 2007; 6:487–493.
Article
23. Linder D, Dreiher J, Zampetti A, Sampogna F, Cohen AD. Seborrheic dermatitis and hypertension in adults: a cross-sectional study. J Eur Acad Dermatol Venereol. 2014; 28:1450–1455.
Article
24. Yaggie JA, Niemi TJ, Buono MJ. Adaptive sweat gland response after spinal cord injury. Arch Phys Med Rehabil. 2002; 83:802–805.
Article
25. Thomas SE, Conway J, Ebling FJ, Harrington CI. Measurement of sebum excretion rate and skin temperature above and below the neurological lesion in paraplegic patients. Br J Dermatol. 1985; 112:569–573.
Article
26. Nash MS. Known and plausible modulators of depressed immune functions following spinal cord injuries. J Spinal Cord Med. 2000; 23:111–120.
Article
27. Cruse JM, Lewis RE, Roe DL, Dilioglou S, Blaine MC, Wallace WF, et al. Facilitation of immune function, healing of pressure ulcers, and nutritional status in spinal cord injury patients. Exp Mol Pathol. 2000; 68:38–54.
Article
28. Dahl MV. Dermatophytosis and the immune response. J Am Acad Dermatol. 1994; 31:S34–S41.
Article
29. Jung KE, Chung J, Park BC, Jee KN, Jee YK, Kim MH. A clinical study of cutaneous adverse reactions to nonionic contrast media in Korea. Ann Dermatol. 2012; 24:22–25.
Article
30. Falanga V, Schachner LA, Rae V, Ceballos PI, Gonzalez A, Liang G, et al. Dermatologic consultations in the hospital setting. Arch Dermatol. 1994; 130:1022–1025.
Article
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