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Open Access Publications from the University of California

Scholarly Works (2 results)

  • Article
  • Peer Reviewed
Dermatology Online Journal, Volume 29, Issue 1 (2023)
We describe a particularly severe case of drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome with hemodynamic instability, erythroderma, profound eosinophilia, and severe organ dysfunction. We attribute the severity in part to a delay in diagnosis due to patient's skin of color, as the erythroderma was not noticed until a dermatologist was consulted. This case highlights how even severe skin disease can present less conspicuously in patients with darker skin types. We outline several strategies that can help clinicians to recognize DRESS and other skin disease phenotypes in patients of color, thereby avoiding delays in diagnosis as seen in this case.
    Cover page: Delayed diagnosis of DRESS syndrome in a patient with skin of colorCreative Commons 'BY-NC-ND' version 4.0 license
    • Article
    • Peer Reviewed
    Dermatology Online Journal, Volume 24, Issue 6 (2018)

    Background: Lengthy wait times for dermatology appointments in the U.S. limit care access. The University of Pennsylvania's Department of Dermatology has established an urgent care clinic (UCC) and an intermediate care clinic (ICC) to expedite appointments for higher acuity patients.

    Objective: To describe our rapid access clinics' operations, referral patterns, and distributions of diagnoses. Methods: We performed a retrospective review of dermatology consult order and appointment data for UCC, ICC, and routine care to determine the number of orders, consult appointments, and follow-up appointments; appointment wait times; and frequencies of diagnoses in referring provider and consult appointments. Press Ganey patient satisfaction ratings were also analyzed.

    Results: The median (interquartile range) wait times for UCC, ICC, and routine care, appointments were 3 (1-8) days, 36 (15-64) days, and 45 (12-97) days, respectively (P<0.001). The proportion of referrals originating from subspecialists varied among UCC (47.6%), ICC (20.2%) and routine care (15.8%), (P<0.001). Distributions of diagnoses differed among UCC, ICC, and routine care. Ratings for most satisfaction metrics were similar across clinic settings.

    Conclusions: Dermatology rapid access clinics within an academic medical center can reduce wait times for higher acuity patients while maintaining patient satisfaction.

      Cover page: Expediting patient appointments with dermatology rapid access clinicsCreative Commons 'BY-NC-ND' version 4.0 license
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