Article Text

Original research
An interview study to determine the experiences of cellulitis diagnosis amongst health care professionals in the UK
  1. Mitesh Patel1,2,
  2. Siang Ing Lee1,
  3. Nick J Levell3,
  4. Peter Smart2,
  5. Joe Kai1,
  6. Kim S Thomas2,
  7. Paul Leighton2
  1. 1Division of Primary Care & National Institute for Health Research, School of Medicine, University of Nottingham, Nottingham, UK
  2. 2Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
  3. 3Dermatology, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, UK
  1. Correspondence to Dr Mitesh Patel; mpatel59{at}


Objectives To explore healthcare professionals (HCPs) experiences and challenges in diagnosing suspected lower limb cellulitis.

Setting UK nationwide.

Participants 20 qualified HCPs, who had a minimum of 2 years clinical experience as an HCP in the national health service and had managed a clinical case of suspected cellulitis of the lower limb in the UK. HCPs were recruited from departments of dermatology (including a specialist cellulitis clinic), general practice, tissue viability, lymphoedema services, general surgery, emergency care and acute medicine. Purposive sampling was employed to ensure that participants included consultant doctors, trainee doctors and nurses across the specialties listed above. Participants were recruited through national networks, HCPs who contributed to the cellulitis priority setting partnership, UK Dermatology Clinical Trials Network, snowball sampling where participants helped recruit other participants and personal networks of the authors.

Primary and secondary outcomes Primary outcome was to describe the key clinical features which inform the diagnosis of lower limb cellulitis. Secondary outcome was to explore the difficulties in making a diagnosis of lower limb cellulitis.

Results The presentation of lower limb cellulitis changes as the episode runs its course. Therefore, different specialties see clinical features at varying stages of cellulitis. Clinical experience is essential to being confident in making a diagnosis, but even among experienced HCPs, there were differences in the clinical rationale of diagnosis. A group of core clinical features were suggested, many of which overlapped with alternative diagnoses. This emphasises how the diagnosis is challenging, with objective aids and a greater understanding of the mimics of cellulitis required.

Conclusion Cellulitis is a complex diagnosis and has a variable clinical presentation at different stages. Although cellulitis is a common diagnosis to make, HCPs need to be mindful of alternative diagnoses.

  • dermatology
  • adult dermatology
  • infectious diseases & infestations
  • qualitative research

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  • Contributors MP was involved with the design of the study, collection and analysis of data, drafting the manuscript and final approval of the manuscript. SIL, NJL, PS, JK, KST and PL were involved with the design of the study, analysis of data, drafting the manuscript and final approval of the manuscript.

  • Funding This study was supported by the Scientific Foundation Board of the Royal College of General Practitioners (grant SFB 2018-31).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available.