Indications for Referring Patients with Atopic Dermatitis (Eczema)

DERMATOLOGY

Refer to a dermatologist when:

  1. The diagnosis is unclear to you.
  2. There is severe or refractory disease; your attempts at management haven’t controlled the symptoms.
  3. The eczema is causing a lot of psychosocial stress such as with work/school attendance.
  4. There is eczema on the face that hasn’t responded to treatment.
  5. The patient has frequent flare-ups.
  6. Oral corticosteroids are needed to control symptoms.
  7. Contact allergic dermatitis is on the face, eyelids, etc.
  8. Topical calcineurin inhibitors, phototherapy, immunomodulators (CsA, MMF, MTX) need to be considered.
  9. There is widespread bacterial superinfection or eczema herpeticum. This is a dermatologic emergency that requires immediate treatment with antibiotics or antivirals. Some patients may need to go to the Emergency room/hospital.

Reference / Further Reading
Am Fam Physician. 2012 Jul 1;86(1):35-42.

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