Skin and nail infections and infestations

Specialty: Dermatology
Age group: Adult

Criteria for referral to public hospital service

• Skin and nail infections and infestations unresponsive to maximum medical management (e.g. regular liquid nitrogen treatment for at least 6 months for warts, antifungal treatment for at least 3 months for fungal nail diseases) and unable to be managed and treated in primary care (e.g. patient is immunocompromised)
  • bacterial folliculitis
  • nail dystrophy
  • molluscum contagiosum
  • pityriasis versicolor
  • scabies
  • tinea
  • warts.

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 impact on activities of daily living including impact on work, study, social activities or carer role
• Findings on physical examination
• If the patient is immunosuppressed
• 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 and immunosuppressants)
• Patient’s age
• If nail infection, microscopy and culture (mycology) results from skin scraping or nail clipping.

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.

Most patients with these conditions should be managed in primary care and do not require referral to a public hospital specialist clinic.

Note. Patients will be discharged back to the care of their GP with a detailed management plan, unless they require ongoing treatment.

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

• Skin and nail Infections and infestations that are adequately managed or not related to immunosuppression.