Dermatology
The Royal Perth Hospital Dermatology Service provides specialist assessment and management of a range of adult skin, hair and nail conditions. Referrals are triaged according to clinical need and the information provided in the referral. For assessment and management information before referral, please refer to Clinician Assist WA Dermatology guidance.
If any of the following are present or suspected, please refer the patient to the Emergency Department, via ambulance if required, or seek emergent medical advice if in a remote region.
- Suspected Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN)
- Suspected severe cutaneous adverse drug reaction (SCAR) with systemic illness, mucosal involvement, widespread blistering or skin detachment
- Severe or rapidly progressive bullous/blistering dermatosis, particularly where there is extensive skin involvement or systemic illness
- Erythroderma with systemic illness, haemodynamic instability or other features requiring acute hospital management
- Severe generalised inflammatory or pustular dermatosis with systemic illness
- Severe skin or soft-tissue infection with systemic toxicity, particularly in an immunocompromised patient
- Any rapidly progressive dermatological condition where delay in acute treatment may result in significant morbidity
RPH Dermatology provides specialist assessment and management of adult dermatological conditions requiring secondary or tertiary care.
Conditions that may be appropriate for referral include:
- skin cancers and skin lesions requiring specialist dermatological assessment
- inflammatory skin disease, including complex or treatment-resistant eczema/dermatitis and psoriasis
- moderate-to-severe or treatment-resistant acne (see acne tab below)
- autoimmune and blistering skin disorders
- pigmentary disorders
- hair and nail disorders requiring specialist assessment
- contact dermatitis and conditions requiring consideration of patch testing
- genital dermatology
- suspected dermatological drug eruptions
- other complex dermatological conditions where specialist diagnosis or management is required
Patients with multiple non melanoma skin cancers, or large lesions likely to require complex reconstruction may be more appropriately referred to Plastic Surgery in the first instance. For more guidance on Plastic Surgery referrals, please refer to Plastics and reconstructive surgery (adult) Referral Access Criteria.
For condition-specific assessment and management guidance prior to referral, refer to the relevant Clinician Assist WA guidance.
- For patients in the East Metropolitan Health Service catchment (PDF 400KB) and the Kimberley, Pilbara and Wheatbelt who require immediate referral to Royal Perth Hospital (RPH) outpatients, please contact the dermatology registrar. They can be contacted by calling the RPH switchboard on 9224 2244.
- An immediate referral is for a patient who requires an appointment within one week.
- Please note who you spoke to and any instructions that you are given.
After verbal clinical handover and agreement with the registrar that the patient requires an appointment with RPH within 7 days please:
- Secure message via healthlink address: rphbhref or
- Email the patient’s referral to: RPH.OutpatientReferrals@health.wa.gov.au
Ensure the referral is:
- marked IMMEDIATE
- the name of the registrar spoken with is written on the referral
- all essential referral information, investigations, clinical photos (where possible) are included
All outpatient referrals should be submitted through the Central Referral Service using the standard outpatient referral pathway. These referrals will be triaged accordingly.
Patients with a suspected dermatological emergency (see tab 1 above) should be directed to the Emergency Department rather than managed through the outpatient referral pathway.
Where available, referrers should consult the relevant Clinician Assist WA dermatology guidance for recommended assessment and management prior to referral.
Referrals should clearly include:
- the reason for referral and specific clinical concern
- duration and progression of the condition
- relevant sites affected and severity
- relevant previous and current treatments, including treatment duration and response where known
- relevant medical history, medications and investigations
- clinical photographs (where possible)
- biopsy results if already available (biopsy is not required prior to referral as diagnostic biopsy can be performed by RPH Dermatology)
Proposed ACORN pilot referral access criteria for adult acne:
For patients: https://www.healthdirect.gov.au/acne
For clinicians (see below):
| Clinical indications for referral | |
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| Pre-referral management | |
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| Mandatory referral information | |
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Copy-and-paste Acne referral template
(Please copy and paste into the CRS free-text referral box and complete fields to ensure urgency of review can be safely triaged.)
| Reason for referral: Severe acne / scarring / inadequate response to treatment / significant psychological impact (please delete any reasons not relevant) Approximate acne duration: Sites affected: Severity: Mild / Moderate / Severe Scarring: Yes / No Previous topical treatments trialled and approximate duration: Previous oral treatments trialled and approximate duration: Psychological or psychosocial impact (if relevant): Response to treatment / adherence (if known): Relevant comorbidities, medications or contraindications: Other relevant information: |
The following are not routinely provided in at RPH Dermatology.
- Paediatric dermatology (<16 years old)
- Cosmetic dermatology
- Routine skin checks without a specific lesion or dermatological concern
- Mohs surgery
- Narrowband UVB therapy
- Treatment of benign skin lesions e.g. seborrheic keratosis
- Laser therapy
EMHS is responsible for providing public health services to the people who reside within its boundaries.
The catchment map (PDF 400KB) outlines the suburb catchment areas for East Metropolitan Health Service (EMHS). The country areas that flow to EMHS are the Kimberley, Pilbara and Wheatbelt
Referral to a hospital for assessment and/or treatment is based around multiple criteria. These include:
- Place of residence – most hospitals have catchments to help service people closer to home. For country patients, the residence of family with whom they will reside whilst attending appointments can be taken into consideration.
- Age – RPH is an Adult Hospital, children are only treated by some hospitals (e.g. Perth Children’s Hospital)
- Hospital location of specialty services – some conditions need designated specialist services that are not available at all hospitals (please see Out of scope / excluded services tab).
Please use this information to guide referrals to the hospital servicing your patient's residence and inform your patients of these criteria when you are referring them for public hospital services via the Central Referral Service (CRS).