Evaluation of Diagnostic Accuracy of Referrals to Dermatology Clinic in Ile-ife, South-western Nigeria.

Abstract

INTRODUCTION: Nigeria is a densely populated country with a population of 182 million. The challenge posed
by the provisions of health care to this ever increasing population has continually justified the need for the
reinforcement of primary health care delivery in Nigeria. This study was therefore conducted to assess the rate of misdiagnosed
dermatoses among patients referred to our dermatology clinic.
MATERIALS AND METHODS: The study which was conducted between January 2016 and June 2016 at the
dermatology clinic of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, involving 273 patients. Relevant data were obtained and analyzed using SPSS version 16.
RESULTS: Patients between the age of 2 and 93 years participated in the study. The mean age of the
participants were (35.6 ± 19.7) years. The males were 50.9% while females were 49.1%. The proportion of
dermatoses arranged in descending order were Infections 38.8%, Dermatitis 17.6%, Acne and acne form
eruptions 8.4%, Skin tumour 7.7%, Papulosquamous eruption 7%,, reactive dermatoses 5.9% and pigmentary
dermatoses were 5.5%; others 9.2%. The study also showed that 36.8% of all the
dermatoses were diagnosed correctly while 63.2% were wrongly diagnosed. Apart from acne and
acneform group of dermatoses with the highest correctly diagnosed dermatoses 63.6%, other
categories of dermatoses were largely misdiagnosed. The proportion of correctly diagnosed dermatoses; Infections (41.5%), Dermatitis (31.2%), Reactive dermatoses (25%), Pigmentary dermatoses
(46.7%), Papulosquamous (15.8%) and Skin tumours (42.9%).
CONCLUSION: The proportion of wrongly diagnosed dermatoses was relatively high among cases referred to
dermatology clinic. This high rate may negatively impact on the efficiency of primary health care delivery
services in Nigeria. The introduction of continued medical education, a
functional two-way referrer system and tele-dermatological practices are recommended to reduce the
deleterious effects of the misdiagnosed dermatoses and improve health service.
Keywords: Dermatoses, referrer, misdiagnosis, dermatology, clinic, primary health, Nigeria.