Dermatology

When writing referral letters, please have a go at describing skin lesions.  It helps reviewers and specialists advise you and may save your patient an unnecessary appointment in secondary care.  The website Dermnetnz has a good description of all the common dermatological terms.  The Primary Care Dermatology Society has similar, plus additional useful information on history and examination.  
 
The following is adapted from Ashton & Leppard's book "Differential Diagnosis in Dermatology" (second edition, 1992).  When describing rashes and skin lesions, please detail the : 
  1. Site and distribution - single / multiple and where on they body.
  2. Shape - discoid, linear, target, annular, gyrate.
  3. Colour - erythematous (blanches on pressure), non-erythematous (meningitis rash), other colour - skin coloured, pink, red, mauve, brown, white, yellow, cream, golden.
  4. Duration - acute or chronic, persistent, relapsing,
  5. Surface features - normal or smooth OR warty, papillomatous / scaly, dry and flakey / Keratin - rough, horn, corn / excoriated / exudate or erosion / crust or ulcer / hairy.
  6. Morphology - flat (macules <1cm and patches >1cm), or raised papules <1cm, vesicles <1cm, pustules <1cm, plaques >1cm, nodules >1cm, bullae >1cm) 

Remember, a good picture can say a thousand words so please upload a photo too wherever possible.  Here's a guide on how to do it via EMIS Web and SystmOne. 

If you are using the Schuco Dermatoscopes bought by York Against Cancer for local practices please click here to watch the guidance video and follow these instructions ;

For practices with WiFi :

  • Turn Handyscope on using switch at top of the device and unlock iPod.
  • Click on Handyscope app whcih will open up on image caputuring page. 
  • Ensure graticule option is turned on by pressing on graticule image and take image by tapping anywhere on the screen. 
  • Once image has been taken, navigate to patients tab within the app. Then tap the + symbol to create new patient.
  • Once the patient has been created, navigate back to local images and tap on the image that has been taken.  Go through the steps on screen such as attaching image to the correct patient and adding image localisation.
  • At the bottom of this screen will be the email option.  Assuming email is set up correctly, this should automatically send image in pre-formatted email including the image and patients details. 

For practices without WiFi :

  1. Turn Handyscope on using switch at top of the device and unlock iPod.
  2. Click on Handyscope app which will open up on image capturing page. 
  3. Ensure graticule option is turned on by pressing on graticule image and take image by tapping anywhere on the screen. 
  4. When image has been captured and saved, open up local images tab within the app.
  5. Tap upload in the top right corner, select the correct image and then tap photo album.  This will transfer the image into the iPod's camera roll ready for upload.
  6. Then plug iPod into computer using charging / USB lead.  Open up files and then transfer image. 

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