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J Am Acad Dermatol. 2001 Aug;45(2):250-5.

Dermatology in primary care: Prevalence and patient disposition.

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1
Departments of Dermatology and Cutaneous Surgery, University of Miami School of Medicine, FL, USA.

Abstract

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.

PMID:
11464187
DOI:
10.1067/mjd.2001.114598
[Indexed for MEDLINE]

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