Inpatient dermatology consultation aids diagnosis of cellulitis among hospitalized patients: A multi-institutional analysis.
BACKGROUND
Given its nonspecific physical examination findings, accurately distinguishing cellulitis from a cellulitis mimicker (pseudocellulitis) is challenging.


OBJECTIVE
We sought to investigate the national incidence of cellulitis misdiagnosis among inpatients.


METHODS
We conducted a retrospective review of inpatient dermatology consultations at Massachusetts General Hospital, University of Alabama at Birmingham Medical Center, University of California Los Angeles Medical Center, and University of California San Francisco Medical Center in 2008. All consults requested for the evaluation of cellulitis were included. The primary outcomes were determining the incidence of cellulitis misdiagnosis, evaluating the prevalence of associated risk factors, and identifying common pseudocellulitides.


RESULTS
Of the 1430 inpatient dermatology consultations conducted in 2008, 74 (5.17%) were requested for the evaluation of cellulitis. In all, 55 (74.32%) patients evaluated for cellulitis were given a diagnosis of pseudocellulitis. There was no statistically significant difference in the rate of misdiagnosis across institutions (P = .12). Patient demographics and associated risk factor prevalence did not statistically vary in patients given a diagnosis of cellulitis versus those with pseudocellulitis (P > .05).


LIMITATIONS
This study was unable to evaluate all patients admitted with cellulitis and was conducted at tertiary care centers, which may affect the generalizability of the results.


CONCLUSIONS
Cellulitis is commonly misdiagnosed in the inpatient setting. Involving dermatologists may improve diagnostic accuracy and decrease unnecessary antibiotic use.
['Strazzula|Lauren|L|', 'Cotliar|Jonathan|J|', 'Fox|Lindy P|LP|', 'Hughey|Lauren|L|', 'Shinkai|Kanade|K|', 'Gee|Sarah N|SN|', 'Kroshinsky|Daniela|D|']
D002481:Cellulitis D005260:Female D006760:Hospitalization D006801:Humans D008297:Male D008875:Middle Aged D012189:Retrospective Studies
cellulitis antibiotics contact dermatitis internal medicine medical dermatology skin and soft-tissue infections stasis dermatitis