Dermatological manifestations in the ICU: a prospective observational analysis

Background Dermatological manifestations are commonly seen in ICU patients, but still there is lack of sufficient literature on the spectrum of skin diseases encountered in the ICU. Objective This study aims to determine the burden of skin diseases in ICU patients by calculating the prevalence and etiology of common cutaneous manifestations observed and to calculate their impact on mortality and length of stay in the ICU. Patients and methods In this prospective study, 946 patients admitted to the ICU during the period from February 2015 till August 2016 were evaluated for the presence of cutaneous manifestations. Skin manifestations were categorized based on their etiology and morphology of lesions. Outcomes of skin manifestations were evaluated on the basis of their impact on the duration of stay and mortality. Results The prevalence of skin manifestations in ICU patients was 32.9%. Most common cutaneous manifestations were due to critical illness or treatment (13.2%), followed by those associated with multisystem disorders (11.5%). On the basis of etiology, the most common manifestations were secondary to infections (27.5%), followed by immune causes (27.2%). Significant mortality was associated in patients with cutaneous involvement (11.2%) in comparison to those without skin diseases (10.8%) (P =0.018). The average duration of stay was also longer in patients with dermatological manifestations adding to significant morbidity in ICU patients (P ≤0.001). Conclusion Through this study we intend to sensitize the dermatologists and intensive care physicians regarding the scope for dermatological referrals in the ICU and need for the collaboration between the two for optimal management.