The following tools may be used in diagnosing and managing patients suffering from a skin condition.
1. Websites
2. Primary Care Treatment Pathways developed by the PCDS
3. Royal College of General Practitioners (RCGP)
4. Clinical Knowledge Summaries (CKS)
CKS from National Institute for Health and Care Excellence (NICE) for dermatology conditions.
Specifically, for common dermatology conditions seen in primary care:
5. Guidelines and best practice
Guidelines in Practice and BMJ Best Practice includes summaries of guidelines and implementation of best practice.
A review-based journal which is free to subscribe to. Quarterly bulletins are produced with an array of clinical articles, practical guides and case studies.
7. Skin of Colour resource
The Centre for Evidence Based Dermatology (CEBD) provides evidence based information of relevance to skin colour.
8. Assessment of disease severity and quality of life
The following tools can be used in clinic to guide treatments and need for specialist referral.
- Psoriasis Area and Severity Index (PASI)
i. Worksheet from British Association of Dermatologists (BAD)
ii. An easy and useful Psoriasis 360 APP can aid with psoriasis assessment in clinic and includes a PASI calculator (available on iOS and android)
- Dermatology Quality of Life Index (DLQI) is a dermatology specific quality of life questionnaire which can be translated to different languages for:
i. Adults - the DLQI is also available on the Psoriasis 360 APP
ii. Children
9. Topical Corticosteroids potency ladder and quantity of application using the Finger Tip Unit (FTU) measure
There are a wide variety of topical corticosteroids available. Wrightington, Wigan and Leigh NHS Trust has produced a useful topical corticosteroid potency ladder chart to support clinicians with identifying which potency a particular corticosteroid is.
The Finger Tip Unit (FTU) is commonly used to explain the quantity of topical corticosteroid that is to be applied to the skin and guides the clinician around quantities to prescribe. Patient.info have a useful information sheet on the FTU which can be translated into different languages.
10. Emollients (Moisturisers)
These are very important in the treatment of inflammatory and dry skin conditions such as eczema and psoriasis, in which their frequent and liberal use will act to restore the skin’s protective barrier and relieve dryness and itching. They can also be used as a wash (soap substitute). The National Eczema Society has a helpful Emollient Factsheet* which can support the patient and clinician to choose the best emollient for them.
*There are many emollient formularies around the U.K. and clinicians should refer to their local guidance.
The MIMS Emollient Sensitiser table lists emollient brands according to the presence of potential sensitising agents within each preparation.
11. Evidence Based Reviews on skin conditions and their treatments
The Centre for Evidence Based Dermatology (CEBD) has Maps of Systematic Reviews collated by topic for Acne, Atopic Eczema, Cellulitis, Hidradenitis Suppuritiva, Psoriasis and Vitiligo.