Dermatologists Must Take an Active Role in the Diagnosis of Cellulitis

Misdiagnosis of cellulitis presents dermatologists with both a responsibility to intervene medically as well as an opportunity to correct misperceptions about the scope of our dermatological clinical practice. Cellulitis is a common cutaneous disease in the United States, with an estimated prevalence of 14.5 million cases per year. Concern for cellulitis leads to about 2.8 million emergency department (ED) visits per year. But as Weng and colleagues demonstrate in this issue of JAMA Dermatology, cellulitis is widely misdiagnosed at a significant and unnecessary cost to our patients and health care system. Heath care costs in the United States are high and rising, and cellulitis misdiagnosis contributes to this larger problem. Weng and colleagues show that anywhere between $250 and $515 million are misspent in this way. In EDs and the inpatient setting, the treatment of cellulitis mimickers as true cellulitis leads to delayed diagnoses, complications, increased costs, and morbidity. We applaud the authors' efforts to quantify this common, expensive, and harmful practice gap, as well as senior author Dr Kroshinsky's continued efforts in this arena.

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