1 / 19

Dermatology Services for Patients with Vulval Disease

Dermatology Services for Patients with Vulval Disease. Current Monthly HHGH (VBw) Monthly WGH(FMT & PM) Quarterly joint Gynae/Derm (VBw & AH) Future Monthly SACH (VBw)?joint with GUM. Vulval Disease. All ages Lichen sclerosis Eczema: seborrhoeic, contact/irritant/ atopic Psoriasis

toki
Download Presentation

Dermatology Services for Patients with Vulval Disease

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Dermatology Services for Patients with Vulval Disease • Current • Monthly HHGH (VBw) • Monthly WGH(FMT & PM) • Quarterly joint Gynae/Derm (VBw & AH) • Future • Monthly SACH (VBw)?joint with GUM

  2. Vulval Disease All ages • Lichen sclerosis • Eczema: seborrhoeic, contact/irritant/ atopic • Psoriasis • Vulval pain syndromes • Lichen planus • VIN • Immunobullous disorders • Hidradentis suppuritiva

  3. Vulval Disease • Dedicated clinic • Increased consultation time • Access to other specialities • Teaching opportunity?

  4. Please don’t refer! • Suspected vulval cancer • (unless melanoma) • STD/warts

  5. Patch Testing Service Dr. Simon Dawe Consultant DermatologistWest Hertfordshire NHS trust

  6. Epidemiology • Point prevalence of eczema in UK 20% • Occupational dermatitis 29% of occupational disease • 4.5 % of population is allergic to nickel • 1-3% of the pop are allergic to ingredients of cosmetics

  7. Patch and Photopatch Testing • To allow confirmation of allergic contact dermatitis and of photo allergic contact dermatitis • To differentiate between allergic and irritant contact dermatitis

  8. What is Patch testing? • To illicit an immune response by challenging already sensitized persons to defined amounts of allergen and assessing the degree of response • Patch testing is not helpful in the assessment of food allergic individuals

  9. Patch Testing

  10. Patch Testing at West Hertfordshire NHS trust

  11. Numbers Tested • We offer a patch testing service at SACH and HH • Patch testing is arranged after an initial clinical assessment and appropriate batteries of allergens selected • Yearly rate 168 patients per year • We are in the process of setting up a dedicated clinic whose remit may widen

  12. Indications for referring for patch testing • Eczematous disorders where contact allergy is suspected or is to be excluded • Eczematous disorders failing to respond to treatment as expected • Chronic hand and foot eczema • Persistant or intermittent eczema of the face, eyelids, ears and perineum • Complicated varicose eczema

  13. Follow up caseload: HELP!!!

  14. Follow up caseload: HELP!!! • Huge reductions in commissioned follow up activity (40%) • CATS will increase complexity of secondary care caseload • Follow up caseload includes skin surgery (good value for you!) • Nurse activity now being counted • ALL A MESS!

  15. HELP!!!!

  16. Dermatology Follow up case load implications of new: follow up 1:1.2 ratio HHGH 31% patients no follow up appointments, SACH 31% patients no follow up appointments, HMH 42% patients no follow up appointments Top ten diagnoses of those needing more than one follow up appointment

  17. Dermatology Nurses Rule: OK?Liz Farley Senior Dermatology Nurse Specialist

  18. GP Referral Nurses and the patient pathway PsoriasisNurse led clinic Leg ulcerNurse led clinic Primary Care clinicNurse support Childrens EczemaNurse led clinic Doctors clinicNurse support Nurse skin surgery Treatments:OintmentsPhototherapyBehavioural treatment Nurse led drug monitoring clinic Discharge Patch testing Reaccess viaNurse led helpline

  19. It’s all about team work … … thank you

More Related