This video from Dr Helen Story, CASES reviewing GP and GP Clinical Assistant in Dermatology at Sheffield Teaching Hospitals, describes the recently developed Actinic Keratosis pathway in Sheffield.
The Primary Care Dermatology Society (PCDS) is the leading Primary Care society for GPs with an interest in dermatology and skin surgery. PCDS is affiliated to the British Association of Dermatologists and the Royal College of General Practitioners. On their website, they claim to have “the most comprehensive diagnostic resource for dermatology on the World Wide Web, in addition to providing concise guidance on the management of common skin conditions.” The clinical chapters provide concise guidance about dermatological conditions and their management.
2) Another popular and authoritative web resource is DermNet New Zealand. This website was founded in 1996 by dermatologists in New Zealand and has since grown to provide extensive information and images on a range of dermatological conditions
3) The Accountable Care Partnership (ACP) Skin Steering Group has developed self-management guidance for patients – covering the top 4 presenting conditions of Eczema, Cysts, Acne and Psoriasis.
Top Ten hints – Dermatology
1. Always use a topical keratolytic (eg benzoyl peroxide, adapalene, isotretinoin, azaleic acid) when prescribing a systemic antibiotic for acne. If irritation is a problem try using a cream base rather than a gel, or start at alternate day applications and increase as tolerated.
2. Ask what your patient washes with – soaps and detergents irritate inflamed skin – a soap substitute may help.
3. Remember that the licensed dose of fexofenadine in urticarial is 180mg not 120mg which may not give adequate control.
4. Most emollients can ‘double up’ as a soap substitute – it is sometimes simpler to have one product instead of two.
5. The British Association of Dermatologists has a wide range of well written patient information leaflets available free to access or download.
6. Consider taking a nose swab from patients who have recurrent infected flares of eczema – if they carry staph aureus then treatment with appropriate nasal antibiotics (see BNF) and an antiseptic wash may help
7. Many patients with actinic keratoses can be managed in primary care – the Actinic Keratoses Management guidelines are now on the Sheffield CCG Press Portal.
8. The Primary Care Dermatology Society has excellent guidance on the workup and care of patients with generalised pruritus.
9. Topical cobetasol propionate can be prescribed to patients with alopecia areata (scalp application or cream) – it may stimulate regrowth while they are waiting their dermatology appointment.
10. A great range of emotional support, self help tools and support groups for people with skin disorders available at skinsupport.org.uk. Changing Faces offers support and cosmetic camouflage for people with appearance altering conditions
Meet the review team