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In a recent retrospective study of patients who were hospitalized with presumed cellulitis, dermatologists concluded that roughly 30% of patients actually had alternative diagnoses (NEJM JW Gen Med Dec 15 2016 and JAMA Dermatol 2017; 153:141). Now, two prospective studies provide additional insight.
In a randomized trial, 175 patients with presumed cellulitis who were admitted to an inpatient hospital unit or an emergency department (ED) observation unit received either mandatory dermatology consultation within 24 hours or no consultation. In the consultation group, 31% of patients were misdiagnosed by the primary team, according to a dermatologist's evaluation. Patients who received dermatology consultation had less antibiotic exposure and …