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Dermatology consultation affects pediatric oncology patient care

Outpatient dermatology consultation changed the diagnosis and the management of disease in children with cancer, affecting their care, according to recently published study results in the Journal of the American Academy of Dermatology.

Researchers conducted a retrospective review of 1,001 pediatric oncology patients with outpatient dermatology visits from 2008 to 2015 at Boston Children’s Hospital.

There were 516 patients (54.7% male) who met criteria and were included in the study.

Hematologic (43.4%) and brain (12.8%) malignancies were the most common primary diagnoses, and the mean time from cancer diagnosis to dermatology visit was 65.2 months for routine skin screening.

Nonmalignant skin eruptions (33.4%) and skin infections (21.3%) were the most common dermatologic diagnoses,

There were 827 diagnoses made during 743 visits. There were significant-impact diagnoses — including squamous cell carcinoma, basal cell carcinoma and other malignancies; adverse cutaneous drug reaction; graft-versus-host disease; varicella-zoster virus; or herpes simplex virus infection — made during 14.7% of the visits.

Viral and bacterial infections were the most common infections, accounting for 66.5% and 14.2% of infections, respectively.

There were 251 pediatric patients given an initial oncology referral to dermatology during study period.

There was a change in diagnosis in 59.8% of patients following consultation with a dermatologist. There also was an overall change in management of the dermatologic disease in 72.4% of patients and a change in medical management of noncutaneous issues in 12.4% of patients.

“Our results suggest that pediatric dermatologists similarly improve diagnostic accuracy, allowing for timely and appropriate intervention in the pediatric oncology population,” the researchers wrote. “Dermatology consultation may affect medical management of noncutaneous issues that have important implications for cancer therapy.”

“Dermatologists can diagnose common nonmalignant cutaneous conditions that may have severe or atypical manifestations; recognize more concerning rare conditions, including cutaneous malignancies; and provide useful and collaborative input for critical medical decisions,” the researchers concluded. – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.