Assessment of dermatitis (eczema) management - dermatology

Specialty: Dermatology
Age group: Adult

Criteria for referral to public hospital service

• Widespread, chronic dermatitis that has not responded to medical management (i.e. soap free washing, regular moisturiser, regular antihistamines and prescribed topical corticosteroid (with or without calcineurin inhibitors)) with functional or psychological impact on quality of life or activities of daily life
• Dermatitis exacerbated by secondary infection
• Allergic contact dermatitis that has not responded to medical management.

Information to be included in the referral

Information that must be provided

• Reason for referral and expectation or outcome, anticipated by the patient, or their carer, and the referring clinician from referral to the health service
• The functional or psychological impact on quality of life or activities of daily living including impact on work, study, social activities or carer role
• Findings on physical examination
• Details of previous management including the course of treatment(s), assessment of adherence to current management plan and outcome of treatment(s)
• Current and complete medication history (including non-prescription medicines, herbs and supplements)
• Patient’s age
• If the patient is pregnant and if the skin condition is thought to be related to the pregnancy.

Provide if available

• Colour photograph(s) – with patient’s consent where secure image transfer, identification and storage is possible. These images often assist with identifying clinical urgency and the most appropriate specialist clinic or service
• If the person identifies as an Aboriginal and/or Torres Strait Islander
• If the person is neurodiverse, gender diverse or has a disability
• If the person is from a culturally and linguistically diverse background.

Additional comments

The Minimum information for referrals to non-admitted specialist services lists the information that should be included in a referral request.

Note. Patients will be discharged back to the care of their GP with a detailed management plan, unless they require ongoing treatment (e.g. systemic medication, narrow band ultraviolet B therapy).

The referral should note if the request is for a second or subsequent opinion as requests for a second opinion will usually not be accepted.

Cosmetic procedures (including laser procedures) without medical indications are currently restricted in Victorian public hospitals and cannot be performed unless specific medical indications exist. The medical indications and clinical thresholds for reconstructive surgery includes venous conditions - chronic dermatitis/eczema.

Where appropriate and available the referral may be directed to an alternative specialist clinic or service.

Referral to a public hospital is not appropriate for

• Previously diagnosed dermatitis that is adequately managed.