Biomedical subjects

R C McConnell

Publications and source records attributed to R C McConnell.

3 recordsLinked to original sources

PubMed1998

Most common dermatologic problems identified by internists, 1990-1994.

BACKGROUND: Internists in all settings see many patients with skin conditions. Thus, their education in dermatology is important. Information on which areas of dermatology are most commonly seen in internal medicine practices is necessary for designing effective educational programs on skin disease. OBJECTIVE: To determine what types of dermatologic problems internists most commonly diagnose. METHODS: National Ambulatory Medical Care Survey data from 1990 to 1994 were analyzed for dermatologic diagnoses. Physicians specializing in internal medicine and all its subspecialties were compared with dermatologists and with other physicians. RESULTS: The most common skin disorders diagnosed by internists were dermatitis (15.8% of all diagnoses) and bacterial skin infections (14.0% of all diagnoses). Combined, bacterial, fungal, and viral infections included 28.3% of the most common dermatologic diagnoses made by internists. The top 10 most common diagnoses accounted for 57.9% of all skin-related diagnoses and the top 20 most common diagnoses accounted for 72.8%. Internists were more likely to see patients for bacterial skin infections, herpes infection, exanthem, urticaria, and insect bites while dermatologists more commonly saw patients for actinic and seborrheic keratoses, warts, benign and malignant skin tumors, and psoriasis. CONCLUSIONS: The most common dermatologic diseases diagnosed by internists differ considerably from those diagnosed by dermatologists. Because dermatologists do much of the dermatology teaching of internal medicine residents, it is important to recognize these differences to place emphasis on the proper areas of study. Some common or serious skin conditions not often diagnosed by internists such as psoriasis and melanoma also deserve attention in internal medicine training programs.

Adolescent↗

PubMed1998

Most topical tretinoin treatment is for acne vulgaris through the age of 44 years: an analysis of the National Ambulatory Medical Care Survey, 1990-1994.

BACKGROUND: Topical tretinoin is effective treatment for both acne and photoaging. This creates a problem for insurers that cover medication costs, because treatment of acne is often covered but treatment of photoaging is not. The age distributions of patients with acne or photoaging are likely to be very different. Therefore, one approach insurers can use is an age cutoff for covering the cost of topical tretinoin therapy. OBJECTIVE: Our purpose was to determine at what age patients are more likely to receive tretinoin for treatment of acne vulgaris versus other conditions to provide a rational basis for insurers to set coverage cutoffs. METHODS: National Ambulatory Medical Care Survey data for the years 1990 to 1994 were analyzed to ascertain the age distribution of acne vulgaris office visits and treatment with topical acne agents including tretinoin. These data were compared to office visits and tretinoin treatment of wrinkles, solar elastosis, and other conditions. RESULTS: The mean age (+/- standard deviation) of patients seen for acne vulgaris was 24.3 +/-11.5 years old. The age distribution of topical tretinoin treatment paralleled the age distribution of acne. Tretinoin treatment of acne and of nonacne conditions were equal at an age of 44. CONCLUSION: The distribution of outpatient visits for acne treatment is skewed toward older patients and persists beyond age 40. A rational age cut-off for coverage of topical tretinoin treatment is 40 years.

Acne Vulgaris↗

PubMed1997

The most common dermatologic problems identified by family physicians, 1990-1994.

BACKGROUND AND OBJECTIVES: Because all family physicians see numerous patients with dermatologic complaints, their education in skin disorders is important. Data are needed to help program directors know which areas of dermatology deserve the most time and emphasis. This study determined what types of skin problems family physicians most commonly diagnose. METHODS: Study researchers analyzed National Ambulatory Medical Care Survey data from 1990 to 1994 for dermatologic diagnoses. We then compared physicians specializing in family practice and its related fields (general practice, family practice sports medicine, and family practice geriatrics) with dermatologists and other physicians. RESULTS: The most common skin disorders diagnosed by family physicians were dermatitis (16.4% of all diagnoses), pyoderma (13.7%), wart (8%), tinea infection (5.4%), and epidermoid cyst (5.1%). The top 10 most common diagnoses accounted for 65% of all skin-related diagnoses, and the top 20 most common diagnoses accounted for 81.8%. Family physicians more commonly saw patients for infectious processes, infestations, and insect bites, while dermatologists were more likely to see patients for psoriasis, alopecia, and rosacea. CONCLUSIONS: Skin disorders diagnosed by family physicians differ considerably from those diagnosed by dermatologists. Because dermatologists do much of the dermatology teaching of family practice residents, it is important to recognize these dissimilarities to place emphasis on the proper areas of study. Some common or serious conditions, such as psoriasis and melanoma, are not often diagnosed by family physicians and also deserve attention in family practice training programs.

Clinical Competence↗