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Patients with sunburn presenting to ED associated with certain characteristics

Patients visiting EDs or urgent care clinics for sunburn treatment were associated with characteristics including psychiatric illness, alcohol use and homelessness, according to recently published study results in JAMA Dermatology.

“Sunburn led to an estimated 33,826 visits to U.S. [EDs] in 2013, resulting in a cost of $11.2 million,” the researchers wrote. “Despite this, burden, little is known about the features of patients utilizing the ED or urgent care clinic for treatment of sunburn.”

The researchers used the Partners Healthcare Research Patient Data Repository to search for ED visits for sunburn to Brigham & Women’s Hospital, Massachusetts General Hospital and associated urgent care clinics between 2000 and 2015 using ICD-9 codes for sunburn.

There were 200 patients (mean age, 43.7 years; 51.5 male) identified with 204 visits for sunburn to the ED (n = 180) or urgent care clinics (n = 24).

Psychiatric illness (9.3%), alcohol use (6.4%) and homelessness (6.4%) were associated patient characteristics, and indoor tanning accounted for 2% of sunburns.

Patients’ most common complications were blistering (37.3%), constitutional symptoms (18.6%) and secondary infections (1%). NSAIDs, acetaminophen with or without opioid (58.3%), and aloe and/or moisturizers (29.9%) were the most common treatments.

Sun-protection counseling was only given for 33.3% of the ED or urgent care clinic visits. Most patients (74.5%) were insured.

IV fluids were required in 8.8% of visits and 2% resulted in admissions, with the researchers suggesting that most treatment could have been given in other care settings or with over-the-counter medications.

“The association of psychiatric illness, alcohol abuse and homelessness with sunburn visits highlights a vulnerable population that should be targeted through public health initiatives,” the researchers wrote. 

Measures including broadening of homeless shelter hours, free sunscreen dispensers, designated shade structures and sunburn risk awareness may reduce risks, according to the researchers.

“It is clear that ED and [urgent care clinic] utilization for sunburn treatment is a largely avoidable phenomenon that leads to considerable costs,” the researchers concluded. “Our study demonstrates possible areas for interventions to reduce disease burden and streamline care.” – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.