Sunburn Often Diagnosed in Outpatient Setting

A new study reported that most patients receive diagnoses of sunburn—a risk factor for skin cancer—in an outpatient setting.

Led by Malgorzata Nowakowska, BS, of Baylor College of Medicine, a team of investigators utilized claims data to evaluate and characterize patients who have been diagnosed with sunburn.

While previous investigations in this matter have primarily relied on self-reported survey responses or exclusively assessed emergency department visits, Nowakowska's team gathered information from a deidentified database of commercially insured patients to better understand the clinical and demographic settings of sunburn.

The Analysis

Using Truven Marketscan and International Classification of Diseases, Ninth Revision [ICD-9] diagnostic codes, the team extracted information on medical encounters between January 2009 – December 2018.

As such, they assessed 186,186 eligible patients with sunburn, who represented a total of 208,777 encounters.

As many as 91.6% of patients had a single sunburn-related encounter, 6.5% of patients had 2 encounters, and 1.9% had 3 or more encounters.

A majority of patients was female (55.3%), and a plurality was younger than 18 years old (26.9%).

The team also reported that only 20% of encounters were based in an emergency or urgent care setting, Further, overall diagnoses were commonly made by dermatologists (26.96%), followed by family medicine clinicians (22.01%).

According to ICD 9 codes, 76.5% of instances were considered nonspecific sunburns, 6.2% were first degree burns, 17.0% were second degree, and 0.3% were third degree. As many as 83.5% of patients were not administered any medical treatments for their burn; in fact, such treatments were more likely used in an emergency/urgent care setting—with the exception of topical steroids.

Conclusions

“Our results indicate that sunburn diagnoses occur across the lifespan, highlighting the need for sun protection for all,” Nowakowska and colleague wrote.

“Our study findings suggest that sunburn is seen in various clinical settings, with an approximately 4:1 ratio of outpatient to emergency/urgent care and with dermatology and family medicine as the most common specialties,” they continued.

They acknowledged the limitations of Marketscan and their analysis, notably the inability to tell whether patients were initially seeking care for their sunburn, or whether these finding were incidental.

Nevertheless, the team indicated that administrative data can help efforts to develop public health initiatives for prevention and detection of skin cancer.

The study, “Clinical Settings and Demographic Characteristics of Patients With Sunburn,” was published online in JAMA Dermatology.