Inpatient consultative pediatric dermatology: an emerging need in an era of increasing inpatient acuity and complexity.

摘要

In the 1956 edition of Pillsbury, Shelley, and Kligman's textbook, Dermatology, the authors observed that the "beneficial effects of a hospital environment upon many types of chronic dermatitis" could be had with "scrupulous nursing care" and "well-selected topical therapy" and that even infants and children might see a "seemingly irreversible inflammatory process of the skin ... reversed to relative normality" (1). At that time, inpatient management of dermatologic problems was commonplace. From 1983 to 1997, nearly half of academic dermatology programs discontinued their dedicated dermatology inpatient beds; furthermore, 79% of programs reported a reduction in overall inpatient dermatology activity. A concomitant doubling of inpatient consultative dermatology activity during this same period occurred as more patients were then admitted to nondermatology services (2).