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Majority of pseudocellulitis cases initially misdiagnosed as cellulitis
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MIAMI BEACH, Fla. — Evaluations by dermatologists determined that almost three-quarters of patients initially consulted for cellulitis were misdiagnosed, according to research presented at the American Academy of Dermatology Annual Meeting.
“Cellulitis is a huge problem in the United States and worldwide, accounting for over 600,000 US hospital admissions in 2010, and costing the health care system $3.7 billion in 2004,” researcher Lauren Strazzula of Massachusetts General Hospital, Boston, said.
Strazzula cited past studies that found that up to 33% of patients initially consulted for cellulitis instead were diagnosed with a cutaneous condition that mimicked it called pseudocellulitis.
To “identify the incidence of cellulitis misdiagnosis, highlight common mimicking conditions and qualify the associated risk factors,” researchers retrospectively reviewed 1,430 inpatient dermatology consultations at four US academic medical centers in 2008. Seventy-five consultations (5.24%; mean age, 56.5 years) were for the evaluation of cellulitis. Sixty-five of those patients had been admitted for rash.
The dermatology teams diagnosed 74.67% of the patients with pseudocellulitis, Strazzula said, and there were no statistically significant differences in basic demographics or risk factors between patients diagnosed with cellulitis or pseudocellulitis.
The most common alternative diagnosis for patients with pseudocellulitis included stasis dermatitis (32% of patients), contact dermatitis (14%) and inflammatory tinea (9%).
“Misdiagnosis of cellulitis is truly a significant problem in the inpatient population,” Strazzula said.
For more information: Strazzula L. S018 – Late-breaking research: Pseudocellulitis among hospitalized patients; a multicenter study revealing the magnitude of the problem. Presented at: American Academy of Dermatology 2013 Annual Meeting; March 1-5, Miami Beach, Fla.