An evaluation of the ambulatory diagnosis and treatment of seborrheic dermatitis in PWH in a regional healthcare system.

IF 1.7 4区 医学 Q3 INFECTIOUS DISEASES
HIV Research & Clinical Practice Pub Date : 2025-12-01 Epub Date: 2025-04-17 DOI:10.1080/25787489.2025.2491891
David Perez, Seble G Kassaye, Carly Herbert, Deniz Ozisik, Aniket Kini, Adam Visconti
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Abstract

Background: Seborrheic dermatitis is a common inflammatory skin condition which disproportionately impacts persons with HIV (PWH). Non-dermatologists, including primary care and HIV clinicians, are often the first providers to diagnose and manage inflammatory dermatoses. Data is lacking regarding the quality of management of such common dermatoses by non-dermatologist compared to dermatologic specialists.

Methods: We evaluated the treatment of and referral patterns for seborrheic dermatitis relative to accepted standards of care among outpatient dermatologists and non-dermatologists in a regional healthcare system. Using a cross-sectional design, we analyzed a random sample of 100 persons 18 years or older with a diagnosis of HIV and more than one visit to a regional primary care or HIV clinician with an ICD code for treatment of seborrheic dermatitis.

Results: Seborrheic dermatitis was the most common specific inflammatory dermatosis among PWH in the healthcare system. Non-dermatologists were significantly more likely to prescribe one medication compared to dermatologists (62.2% vs. 50.9%, p = 0.05). 28.9% of persons initially diagnosed by a non-dermatologist were referred to a dermatology specialist. When considering immediate initiation of treatment as optimal management, 33/45 (73.3%) of non-dermatologists had optimal management compared with 53/55 (96.4%) of dermatologists (p < 0.01). However, when considering referral as optimal management, then 86.7% of patients initially diagnosed by non-dermatologists were optimally managed.

Discussion: Seborrheic dermatitis remains a common issue among PWH in a multispeciality ambulatory setting. Non-dermatologists appear significantly less likely to provide optimal initial management which may affect quality of life given potential for delayed treatment in settings with limited specialists. Additional training should be provided to non-dermatologists to facilitate appropriate treatment of common inflammatory dermatological conditions.

在一个地区的卫生保健系统的诊断和治疗脂溢性皮炎在PWH的动态评价。
背景:脂溢性皮炎是一种常见的炎症性皮肤病,对HIV感染者(PWH)的影响尤为严重。非皮肤科医生,包括初级保健和艾滋病毒临床医生,通常是诊断和管理炎症性皮肤病的第一批提供者。与皮肤科专家相比,非皮肤科医生对这类常见皮肤病的管理质量缺乏数据。方法:我们评估了脂溢性皮炎的治疗和转诊模式,相对于门诊皮肤科医生和非皮肤科医生在区域医疗保健系统中公认的护理标准。采用横断面设计,我们分析了100名18岁或18岁以上的随机样本,这些人被诊断为艾滋病毒,并且有ICD代码访问过一次以上的区域初级保健或艾滋病毒临床医生,以治疗脂溢性皮炎。结果:脂溢性皮炎是PWH中最常见的特异性炎症性皮肤病。非皮肤科医生比皮肤科医生更有可能开出一种药物(62.2%比50.9%,p = 0.05)。28.9%最初由非皮肤科医生诊断的人士转介至皮肤科专科医生。当考虑立即开始治疗作为最佳管理时,33/45(73.3%)的非皮肤科医生有最佳管理,而53/55(96.4%)的皮肤科医生有最佳管理(p讨论:脂溢性皮炎仍然是多专科门诊环境中PWH的常见问题。非皮肤科医生似乎不太可能提供最佳的初始管理,这可能会影响生活质量,因为在专家有限的情况下可能会延迟治疗。应向非皮肤科医生提供额外的培训,以促进对常见炎症性皮肤病的适当治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.90
自引率
6.20%
发文量
15
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