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Inflammatory dermatoses

Red flags

Consider urgent referral possibly to DEM for patients with the following

  • Extensive severe skin involvement
  • Extensive secondary skin infection
  • Flare up of extensive psoriasis

The following features may lead to more urgent categorisation

  • Extensive involvement
  • Poor control despite optimum management
  • Mycosis fungicides (Biopsy essential)
  • Guttate psoriasis

Conditions covered in this category are:

  • Eczema
    • Atopic
    • Numular
    • Asteatotic
    • Icthyotic
  • Dermatitis
    • Seborrhoeic
    • Contact
    • Allergic
      • Hives
    • Chemical
    • Lichen planus
  • Psoriasis (see separate section) (if severe arthropathy is present refer also to Rheumatology)
  • Rosacea

Other important information for referring practitioners

Lifestyle changes

  • Encourage healthy lifestyle
    • Stop smoking

Medical management

  • Ensure compliance with use of topical medications and emollient baths etc.
  • If persistent flare up of usually well controlled chronic eczema consider secondary infection and trial antibiotic treatment
  • Most moderately severe psoriasis should be under the care of dermatology especially if prone to inflammatory flare ups.

Referral requirements

A referral may be rejected without the following information.

Essential referral information

  • Presence of any Red Flags
  • Reason for referral
  • Relevant clinical history
    • Description of skin condition
    • Sites affected with severity
    • Treatments trialled and reasons for failure
  • Detailed medication history including any allergy
  • If seen previously by Dermatologist include last two letters
  • Occupational history if relevant
  • Family history if relevant
  • Any relevant histology
    • Important if chronic

Additional referral information (useful for processing the referral)

  • Histology especially in chronic skin conditions
  • Skin swabs/ scrapings

Out of catchment

Metro North Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service. If your patient lives outside the Metro North Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.

  • Impact on employment
  • Impact on education
  • Impact on home
  • Impact on activities of daily living
  • Impact on ability to care for others
  • Impact on personal frailty or safety
  • Identifies as Aboriginal and/or Torres Strait Islander

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can’t order, or the patient can’t afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

  • Presenting symptoms (evolution and duration)
  • Physical findings
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • Body mass index (BMI)
  • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
  • Current medications and dosages
  • Drug allergies
  • Alcohol, tobacco and other drugs use

  • Full name (including aliases)
  • Date of birth
  • Residential and postal address
  • Telephone contact number/s – home, mobile and alternative
  • Medicare number (where eligible)
  • Name of the parent or caregiver (if appropriate)
  • Preferred language and interpreter requirements
  • Identifies as Aboriginal and/or Torres Strait Islander

  • Full name
  • Full address
  • Contact details – telephone, fax, email
  • Provider number
  • Date of referral
  • Signature

  • Willingness to have surgery (where surgery is a likely intervention)
  • Choice to be treated as a public or private patient
  • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)
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