A total of 390 patients admitted to medical wards were recruited into the study. The demographic characteristics and prevalence of dermatological disorders among these patients has been shown in table . The mean age was 36.7 years (SD ± 17.9) with the majority (52.3%) being young adults aged 18 - 44 years and 56.7% (221/390 were females. Overall, 232/390 patients (59.5%) had co-existing dermatological disorders with 49% (191/390) having one, 9% (36/390) two and 5 patients (1%) three. Patients in age groups 18-31 years (70%) and 32-44 years (66%) had the highest prevalence than the other age groups (p = 0.01 and 0.04 respectively).
The prevalence of dermatological disorders among patients admitted to medical wards distributed by age and sex (n = 390)
Table shows the dermatological disorders among patients admitted to medical wards. A wide range of skin diseases was encountered, the most diverse being non-infectious conditions which put together accounted for 36.4% (142/390), while infectious dermatoses accounted for 31.5% (123/390). The common non infectious skin diseases were pruritic papular eruption of HIV/AIDS (PPE) present in 4.3% (17/390), seborrheic dermatitis in 3.8% (15/390), non specific ulcers in 3.8% (15/390) followed by acne vulgaris and keloids, all present in 3%. The common infectious dermatoses were superficial fungal infections at a prevalence of 18% (70/390) with dermatophytoses (tinea) accounting for 10%, pityriasis versicolor 4.6% and oral thrush 3.3%. The commonest dermatophytoses were tinea corporis and tinea unguium both with prevalence of 3.6%. Bacterial skin infections (pyodermas) were seen in 7% (28/390), viral infections in 5% and 4 patients (1%) had scabies. Kaposi's sarcoma was the commonest malignancy observed in 11/390 (2.8%) of the 12 patients with cutaneous neoplasms. One patient had squamous cell carcinoma.
Dermatological disorders among patients admitted to medical wards (n = 390)
Table shows the pattern of dermatological disorders as detected at pre-admission, admission and post-admission periods. Out of 390 admitted patients, 41(10.5%) were reported as having dermatological disorders pre-admission, with Kaposi's sarcoma being over diagnosed in 3 patients giving a false prevalence of 3.6% against the actual prevalence of 2.8%. At admission, 20% were reported as having dermatological disorders, the leading diagnoses being fungal infection in 5.1%. Kaposi's sarcoma was reported in 15 patients (3.8%) being an over diagnosis by 4 patients. In the post-admission period when patients were thoroughly reviewed and dermatological diagnoses established, confirmed or ruled out, a total of 232/390 (59.5%) patients were found to have dermatological disorders. In general, of the 232/390 patients with dermatological disorders, 191/232 (82.3%) and 154/232 (66.3%) had been overlooked by the referring and admitting doctors respectively.
Dermatological disorders diagnosed at pre admission, admission and post admission periods among patients admitted to medical wards (n = 390).
Table shows the pattern of co-existence between dermatological disorders and other medical diseases. Overall, 133/390 (34.1%) patients were admitted due to infectious diseases and of these, 82% (109/133) had co-existing dermatological disorders. The infectious diseases which had co-existing dermatological disorders were: HIV disease (86/109; 79%), tuberculosis (13/109; 12%), malaria (7/109; 6.4%), meningitis, (2/109; 2%) and pneumonia (1/109; 1%). Dermatological disorders which mostly co-existed with HIV disease included Kaposi's sarcoma (11/11; 100%), PPE (15/17; 88.2%), oral candidiasis (11/13; 8.6%), psoriasis (4/5; 80%) common warts (10/13; 77%), and seborrheic dermatitis (10/15; 66.7%).
The frequency of co-existence of dermatological disorders with systemic diseases among patients admitted to medical wards (n = 390)
Thirty three patients were admitted due diabetes mellitus and 22 of them (66.7%) had co-existing dermatological disorders commonly tinea lesions 45.4% (10/22) and ulcers 18.1% (4/22). Among 75/390 (19.2%) patients with cardiovascular diseases, 33 (44%) had co-existing dermatological disorders. Fifty five patients (14%) were admitted due to hematological diseases and 43.6% (24/55) had co-existing dermatological disorders: leukemia (9/24; 37.5%), sickle cell disease (9/24; 37.5) and anemia (6/24; 25%). Among 29 (7.4%) patients with renal diseases, 16 (55.1%) had co-existing dermatological disorders while of the 19 patients (4.9%) admitted due to liver diseases, 12 (63.1%) had co-existing dermatological disorders, mostly xerosis generalisata and prurigo simplex. Twenty six patients (6.7%) were admitted due to solid malignancies and of these, 12 (46.1%) had co-existing dermatological disorders.