Topical corticosteroid use for atopic dermatitis in the pediatric emergency department.

Autor: Wang JF; The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, NY, USA., Young TK; The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, NY, USA., Melnick LE; The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, NY, USA., Orlow SJ; The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, NY, USA.; Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA., Oza VS; The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, NY, USA.; Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA.
Jazyk: angličtina
Zdroj: Pediatric dermatology [Pediatr Dermatol] 2021 Sep; Vol. 38 (5), pp. 1127-1131. Date of Electronic Publication: 2021 Apr 19.
DOI: 10.1111/pde.14606
Abstrakt: Background/objectives: To investigate the evaluation and management of atopic dermatitis (AD) in the pediatric emergency department (PED).
Methods: This retrospective chart review was performed at the PED of a single institution and examined data from 2012 to 2017. Of 335 visits from patients 18 years and younger coded for AD, 167 visits with documented findings that supported a diagnosis of AD according to guidelines from the American Academy of Dermatology were included.
Results: The mean age of presentation was 6.3 years (standard deviation [SD]: 5.9). Of 11 patients with multiple visits, the mean between-visit interval was 31 days (SD: 41). Topical corticosteroids (TCSs) were not prescribed or recommended in 63/167 visits. In an additional 46/167 visits, over-the-counter topical hydrocortisone was recommended. Of prescribed TCS, the mean TCS class was 5.5 (SD: 1.9). 61/104 recommended or prescribed TCSs were weak (Class 7), the most likely used class (P < .001). Dermatology consultation was requested in 14/167 visits and was associated with higher rates of TCS prescriptions (13/14 vs 91/153, P = .018), a higher mean class of TCS prescribed (3.1 vs 5.9, P < .001), higher prescription rates of systemic antibiotics (8/14 vs 10/153, P < .001), and higher recommendation rates for emollient usage (10/14 vs 46/153, P = .005).
Conclusions: Most patients presenting to the PED for AD were either not prescribed a TCS or were prescribed a weak TCS, often one that is over-the-counter. While there may be a variety of explanations for these findings, it is possible they reveal a practice gap regarding AD management in the PED.
(© 2021 Wiley Periodicals LLC.)
Databáze: MEDLINE
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