Analysis of Dermatology referrals and diagnostic accuracy in a medical college

Background: Dermatology referrals play a vital role in patient care as well as in training for non-dermatologists. In present scenario of changing health care need and delivery, it would be of interest to doctors and policy makers to know the magnitude and reasons for dermatology consultations and its impact on patient care. Aims and Objectives: This study was conducted to describe demography of dermatology referrals and to analyse diagnostic accuracy of non-dermatologists and its impact on patient care. Materials and Methods: This cross-sectional study was conducted at Manipal College of Medical Sciences, Pokhara. Preformed proforma having demographic data and details of referrals were recorded. Analysis of diagnostic accuracy by non-dermatologist was carried out. Results: Out of 174 referrals, men and women were equal in number with Mean age of 35.6 ± 22.3 years. Referrals were more frequent from Internal medicine 40 (23%). The most common complaint in referral sheet was skin rashes of different types in 85 (48.9%). Primary department didn’t offer treatment for skin lesions/symptoms in 73 (42%) of cases. After receiving referrals, dermatologists were able to diagnose clinically in 110 (63.2%) cases, in the rest, help of laboratory, imaging techniques and histopathology were needed. Cutaneous viral infections were the commonest dermatological diagnosis in 30 (17.2%) cases, followed by eczema/dermatitis in 174 (2.3%) cases. Primary department made correct diagnosis in only 83 (47.7%) cases. Conclusions: Non-dermatologists do have difficulties in identifying and addressing skin lesions and symptoms and there is benefit from dermatology consultations. Furthermore, dermatology consultations do have high educational value for non-dermatologists.