Dermatology is a medical-surgical specialty in which most of the day-to-day work is performed in outpatient clinics. However, the few studies that have recorded the activity of dermatology outpatient clinics1–3 only analyzed short periods.

Knowing which diseases consume the most resources facilitates decision making and the order in which decisions should be taken to improve outcomes in terms of health, efficiency, use of technology, and management of human resources.1,4

Studies have recently been published on diseases managed in the emergency department5,6 in various Spanish hospitals. Data were obtained from sources other than the electronic clinical history (ECH) and without using controlled language. Studies on surgical activity based on the ECH have also been published.7,8

We present the most relevant results of a registry of activity at the outpatient clinic of the Dermatology Department of Hospital Universitario de Fuenlabrada, Fuenlabrada, Spain in 2009 and 2010 (all activity takes place in the hospital). The data used in the study were obtained from a purpose-designed database retrieved from the ECH and with diagnoses adjusted to a local vocabulary created in December 2008 and based on the Systematized Nomenclature of Medicine, Clinical Terms. The local vocabulary list for diagnoses and treatments was created jointly with the hospital Coding Unit and enabled health problems to be combined for subsequent data analysis.

Between January 1, 2009 and December 31, 2010, we analyzed the number of visits per year, the number of visits per disease, the number of visits per patient and disease, and the number of procedures performed overall and for individual diseases. A procedure was considered any class of activity provided by a health professional or by a health care organization for the benefit of the person receiving the care; therefore, phototherapy was included as a procedure.

The distribution by sex, the total number of contacts and procedures, and the number of procedures per disease were very similar during the study period.

The diseases for which most resources were consumed (number of visits per year) were psoriasis, acquired melanocytic nevus, and common warts. However, each new diagnosis of nevus generated few checkups, in contrast with psoriasis or warts, which generated a larger number of checkups. Psoriasis was the disease that generated the largest number of procedures, followed by common warts.

The data obtained in this study confirm that psoriasis consumes the most resources, since it is responsible for 1 in 10 visits to the dermatology department of our hospital, even though its incidence and prevalence are lower than those of other diseases, such as acquired melanocytic nevus, seborrheic and actinic keratosis, and acne.

We think that the health system could be streamlined by means of specific interventions against diseases that consume such a large quantity of resources owing to the number of visits and procedures, rather than to their severity or to the complaint itself.