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Dermatology at Westmead Hospital

Referral Process

Outpatient Clinic Referrals

Outpatient Clinic referrals are triaged by our medical staff. Please send as much information as possible to assist us with managing your referral.

How to Refer

Fax the referral letter to: 8890 9673

or

Mail the referral letter to:

Dermatology Department
Westmead Hospital
D5a, CD Block
Hawkesbury Road
Westmead NSW 2145

 

Urgent Referrals

For urgent referrals (i.e. referrals for the conditions listed below), please phone the Westmead Hospital switchboard on 02 8890 5555 and ask for the dermatology registrar on call or ask the patient to present to our Emergency Department:

  • Acute cutaneous drug reactions
  • Stevens Johnson syndrome / toxic epidermal necrolysis
  • Erythroderma
  • Disseminated HSV, HVZ infection / eczema herpeticum
  • Generalised pustular eruptions (psoriasis or drug eruptions)
  • Acute bullous eruptions
  • Vasculitis
  • Severe cystic lesions
  • Suspected melanoma

 

Routine Referrals

Referral Process

All referrals must include:

  • Level of urgency
  • Name, age, date of birth
  • Address
  • Contact telephone numbers
  • Medicare number
  • Specific clinical problems requiring consultation
  • Preferred Language. Please indicate if interpreter is needed
  • Copy of results of relevant investigations performed within the previous 12 months
  • List of current medications

How to Refer

Fax the referral letter to: 8890 9673

 

** Denotes urgent referrals

Condition

Symptoms

Notes (Assessment/investigation recommended before referral)

Severe Acne

  • Extensive disease or nodules and scars
  • Poor response to at least 6 months of one oral antibiotic and topicals

 

Alopecia

  • Persistent or extensive alopecia
  • Scarring alopecia
  • Diagnostic uncertainty

 

Connective Tissue diseases

  • Morphoea
  • Lupus erythematosus
  • Dermatomyositis
  • Mixed connective tissue
  • Opinion and management

FBE, UEC, LFT, ANA, ESR

Eczema

  • Failure to respond to continuing use of moderately potent steroids
  • Chronic lichenified eczema
  • Eczema herpeticum **
  • Acute infected eczema
  • Erythroderma **
  • Allergic contact eczema

 

Molluscum contagiosum

  • Extensive, painful or inflamed lesions
  • Immunosuppressed patients

 

Squamous Cell Carcinoma

  • Urgent referral for rapidly growing tumours **
  • High risk sites (lips, ears, recurrent lesions)
  • High risk patients (i.e. Immunosuppressed)
  • Diagnosis uncertain

 

Basal Cell Carcinoma

  • Suspected BCC
  • Morphoeic or sclerosing BCC
  • High risk sites (i.e. nasolabial folds)
  • High risk patients (i.e. Immunosuppressed)
  • Patients with multiple tumours

 

Solar keratosis, Actinic keratosis, Bowen’s disease

  • Diagnosis uncertain (SCC until proven otherwise)
  • Painful or rapidly growing lesions
  • Extensive disease
  • Extensive sun damage
  • Treatment failures
  • Immunosuppressed

 

Nail dystrophy

  • Suspicion of sub-ungal tumors
  • Failure of fungal infections to respond to treatment

FBE, UEC, LFT, TSH, T4, Fe studies

Pruritus

  • Diagnosis uncertain
  • Uncontrolled itch

(Exclude: Fe deficiency anaemia, thyroid disease, chronic renal failure, liver disease, lymphoproliferative disease, drug reaction.)

Psoriasis

  • Diagnosis uncertainty
  • Extensive disease
  • Occupational disability
  • Involvement of sites that are difficult to treat (palms, soles, genitals)
  • Failure of appropriate topical treatment
  • Severe or recalcitrant disease requiring systemic therapy
  • Erythrodermic psoriasis **
  • Pustular psoriasis **

FBE, UEC, LFT.

(For patients being considered for systemic treatment)

Porphyria

  • Diagnosis uncertain
  • Fragile skin and blisters on sun exposed sites.

FBE, UEC, LFT, faecal and urinary porphyrins, RBC porphyrins

Rosacea

  • Severe unresponsive disease
  • Rhinophyma
  • Severe telangiectasia
  • Keratitis: Refer to Ophthalmology

 

Urticaria

  • Persistent urticaria for three months, unresponsive to three different antihistamines each for 4-6 weeks
  • Urticarial vasculitis with associated joint pains, persistent wheals or bruising
  • Angioedema: consider referral to Immunology

 

Melanoma

  • Suspected or proven ** 

 

Multiple Moles

  • More than a 100 moles
  • More than 5 atypical moles

 

Bullous diseases

  • Diagnosis uncertain
  • Unresponsive to treatment

 

Drug Reactions

  • Fixed drug reaction
  • Erythema multiforme
  • Other drug related exanthemas

 

Atypical lymphocytic infiltrates

  • Cutaneous lymphoma
  • Pseudolymphoma
  • Drug reactions

 

Other conditions

  • Panniculitis
  • Granulomatous diseases
  • Infective conditions

 

 ** Denotes urgent referrals

 

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