Royal North Shore Hospital provides the following Dermatology clinics:
- General dermatology
- Paediatric dermatology
- Skin surgery
- High risk skin cancer (including post- organ or stem cell transplantation)
- Hidradenitis suppurativa
- Neurofibromatosis
- Male genital dermatology
- Female genital dermatology
- Mohs micrographic surgery (not for direct GP referral)
- Phototherapy unit
The following conditions should be immediately referred to the Emergency Department and be discussed with the on call dermatology registrar:
- Extensive blistering including suspected toxic epidermal necrolysis
- Purpuric (bruise-like) rashes
- Widespread and symptomatic drug eruptions
- Erythroderma (>90% body rash)
- Generalised pustular psoriasis
- Eczema herpeticum
- Skin infections in immunosuppressed patients
Mandatory referral information
All Dermatology referrals must include a consultant being referred to in RNSH outpatients. If unsure, please address to Professor Gayle Fischer.
All referrals must include patients details including a telephone number, the reason for referral, clinical findings, treatment to date, provisional diagnosis, the impact on the patient, and any significant medical history, medications and relevant social information.
Please indicate preferred language if an interpreter is required.
Please attach results of any investigations to the referral and ensure the patient brings hard copies to their appointment. This will help avoid unnecessary duplication of tests, additional appointments and delay.
Referrals with insufficient information will be returned until further information is provided to the clinic.
|
Presenting Complaint
|
When to Refer
|
RNSH Clinic
|
|
Head and neck skin cancers
|
Head and neck skin cancer (non melanoma)
|
Mohs Micrographic Surgery (contact on-call registrar to discuss prior to referral)
|
|
Vulval dermatological disease
|
Dermatological conditions of the female genitals of uncertain diagnosis or unresponsive to first-line treatment
- Refer immediately and mark urgent if lesion of concern or ulceration
|
Female Genital Dermatology clinic
|
|
Male Genital Dermatological Concerns
|
Dermatological conditions of the male genitals of uncertain diagnosis or unresponsive to first-line treatment
- Refer immediately and mark urgent if lesion of concern or ulceration
|
Male Genital Dermatology clinic
|
|
Hidradenitis suppurativa
|
Patients with a history of recurrent abscesses/boils in axilla, groin or submammary region, where Staph infection has been ruled out.
|
General Dermatology clinic
|
|
High risk skin cancer
|
Patients who are immunosuppressed as a result of undergoing organ or stem cell transplant, or other significant immunosuppression
|
High risk skin cancer clinic
|
|
Paediatrics
|
Patients under 16 with skin complaints including:
- Eczema: refer if TCS has not been successful and systemic therapy to control eczema is required; further therapy is necessary, e.g. phototherapy or immunosuppressants; or uncertainty about diagnosis
- Psoriasis
- Vascular lesions (including birthmarks) in cosmetically or functionally significant sites
- Acne: refer if inadequate response to topical/antibiotic therapy or scarring
- Skin infections, where antibiotic treatment has failed
- Acute skin conditions of uncertain diagnosis
- Lesions of concern not otherwise described
|
Paediatric Dermatology Clinic
|
|
Presenting Complaint
|
When to Refer
|
RNSH Clinic
|
|
Phototherapy
|
Requiring phototherapy – UVA/UVB light therapy
|
Phototherapy Unit
|
|
Cutaneous malignancy
|
Requiring surgical management for cutaneous malignancy
|
Dermatology Surgery Clinic
|
|
Neurofibromatosis skin concerns
|
Patients wanting treatment of the cutaneous manifestations of neurofibromatosis.
|
Neurofibromatosis clinic
|
|
Ongoing skin surveillance after melanoma treatment
|
For skin surveillance after treatment for melanoma
|
General Dermatology
|
|
Suspicious pigmented skin lesion
|
If concern about diagnosis of melanoma or other skin cancer, but excisional biopsy unable to be performed in primary care (NOT for skin checks)
|
General Dermatology
|
|
Inflammatory skin conditions
|
Eczema inadequately responding to topical therapies
|
General Dermatology
|
|
Psoriasis inadequately controlled with topical corticosteroid and vitamin D analogue treatments
|
|
Skin infections not resolved with antibiotic therapy
|
|
Treatment-resistant inflammatory skin conditions
|
|
Autoimmune conditions: immunobullous disease (bullous pemphigoid, pemphigus), cutaneous lupus, dermatomyositis, lichen planus
- Refer if autoimmune cause suspected or for management after diagnosis confirmed
|
|
Chronic urticaria not responding to high-dose antihistamines taken regularly for 6 weeks
|
|
Undiagnosed skin conditions with blistering, ulceration, scarring or debilitating symptoms
|
|
Failure of all other treatments
|
Patients who have failed all other treatments and qualify for subsidised biological agents. Must be referred from a specialist.
|
General Dermatology Clinic
|
The RNSH Dermatology Clinic is unable to provide a service for the following:
- Routine skin checks
- Venous ulceration (refer to Vascular Clinic)
- Cosmetic conditions
- Laser dermatology
Out of Area Referral
- Resident of NSLHD catchment – Yes, referral accepted at RNSH
- Referral from other specialist, for specialist opinion – Yes, referral accepted at RNSH
- Resident of other LHD that DOES NOT provide the clinic service, e.g., rural, outer metro – Yes, but service or problem needs to be documented on the referral
- Continuing care of existing condition we already manage – Yes, provided existing or related condition documented on the referral
- Demonstrated complexity requiring services of RNSH ACC – Yes, but reason must be explicitly documented on referral
- Compassionate circumstances (e.g. family proximity, staff) – Yes, but reason must be explicitly documented on referral
- Resident of other LHD that offers the service – Refer to local LHD
Check if the home address is within Northern Sydney Local Health District here: https://www.health.nsw.gov.au/lhd/Pages/lhd-maps.aspx
