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

Mail the referral letter to:

Dermatology Clinics Level 2
G2 Outpatient Clinics Near Main Reception of Westmead Hospital
Opposite McBeath Pharmacy Westmead NSW 2145

Email: [email protected]

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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