Abstract:
Background: Skin diseases are underestimated and overlooked by most clinicians despite being common in
clinical practice. Many patients are hospitalized with co-existing dermatological conditions which may not be
detected and managed by the attending physicians. The objective of this study was to determine the burden of
co-existing and overlooked dermatological disorders among patients admitted to medical wards of Muhimbili
National hospital in Dar es Salaam.
Study design and settings: A hospital-based descriptive cross-sectional study conducted at Muhimbili National
hospital in Dar es Salaam, Tanzania.
Methods: Patients were consecutively recruited from the medical wards. Detailed interview to obtain clinicodemographic
characteristics was followed by a complete physical examination. Dermatological diagnoses were
made mainly clinically. Appropriate confirmatory laboratory investigations were performed where necessary. Data
was analyzed using the ‘Statistical Package for Social Sciences’ (SPSS) program version 10.0. A p-value of < 0.5 was
statistically significant.
Results: Three hundred and ninety patients admitted to medical wards were enrolled into the study of whom,
221(56.7%) were females. The mean age was 36.7 ± 17.9 (range 7-84 years). Overall, 232/390 patients (59.5%) had
co-existing dermatological disorders with 49% (191/390) having one, 9% (36/390) two and 5 patients (1%) three. A
wide range of co-existing skin diseases was encountered, the most diverse being non-infectious conditions which
together accounted for 36.4% (142/390) while infectious dermatoses accounted for 31.5% (123/390). The leading
infectious skin diseases were superficial fungal infections accounting for 18%. Pruritic papular eruption of HIV/AIDS
(PPE) and seborrheic eczema were the most common non-infectious conditions, each accounting for 4.3%. Of the
232/390 patients with dermatological disorders, 191/232 (82.3%) and 154/232 (66.3%) had been overlooked by their
referring and admitting doctors respectively.
Conclusion: Dermatological disorders are common among patients admitted to medical wards and many are not
detected by their referring or admitting physicians. Basic dermatological education should be emphasized to
improve knowledge and awareness among clinicians.
