4 research outputs found
Dermatological Manifestations in the Intensive Care Unit: A Practical Approach
Dermatological problems are not usually related to intensive medicine because they are considered to have a low impact on the
evolution of critical patients. Despite this, dermatological manifestations (DMs) are relatively frequent in critically ill patients. In
rare cases, DMs will be the main diagnosis and will require intensive treatment due to acute skin failure. In contrast, DMs can be a
reflection of underlying systemic diseases, and their identification may be key to their diagnosis. On other occasions, DMs are
lesions that appear in the evolution of critical patients and are due to factors derived from the stay or intensive treatment. Lastly,
DMs can accompany patients and must be taken into account in the comprehensive pathology management. Several factors must
be considered when addressing DMs: on the one hand, the moment of appearance, morphology, location, and associated
treatment and, on the other hand, aetiopathogenesis and classification of the cutaneous lesion. DMs can be classified into 4 groups:
life-threatening DMs (uncommon but compromise the patient’s life); DMs associated with systemic diseases where skin lesions
accompany the pathology that requires admission to the intensive care unit (ICU); DMs secondary to the management of the
critical patient that considers the cutaneous manifestations that appear in the evolution mainly of infectious or allergic origin; and
DMs previously present in the patient and unrelated to the critical process. (is review provides a characterization of DMs in ICU
patients to establish a better identification and classification and to understand their interrelation with critical illnesses
Classification of dermatological disorders in critical care patients: a prospective observational study
Purpose: The objective of this study was to identify dermatological disorders detected in the intensive
care unit (ICU), to analyze their specific characteristics, and to define a useful classification for intensive
care physicians.
Materials and Methods: This was a prospective, observational study over a 3-year period (2006-2009)
in a mixed ICU. This included all patients presenting with dermatological disorders that were detected at
the time of ICU admission or developed along the ICU stay. We recorded the specific characteristics of
the disorders and its evolution and treatment, which enabled us to classify the different observed
conditions. As general variables, we analyzed demographic factors, the principal diagnosis, ICU
procedures, the severity score (Acute Physiology and Chronic Health Evaluation II), length of stay, and
mortality.
Results: One hundred thirty-three patients showed at least one dermatological disorder (9.3%) and were
classified into (1) preexisting dermatological disorders, (2) life-threatening dermatologic disorders, (3)
systemic dermatological disorders, (4) infectious dermatological disorders, (5) reactive dermatological
disorders, and (6) others.
Conclusions: Dermatological disorders are a frequent problem in the ICU, and their recognition is key to
set up an appropriate care plan. We propose a classification and description of the different types of
dermatological disorders that are most commonly found in ICUs.
© 2013 Elsevier Inc. All rights reserved