Dr Art O’Hagan, Consultant Dermatologist Skin disease is most prevalent disease in under 16s (1 in 5 babies have eczema) and the second most common disease in adults Each year 24% of the population present to their GP with a skin problem. Skin cancer is the most common form of cancer in the UK and malignant melanoma incidence rates in Britain have more than quadrupled since the 1970s. Locally agreed clinical care pathways are essential to support equity of access to care, best clinical practice and optimum care outcomes. Agreed care pathways facilitate seamless care for people accessing services. Severe acne / acne fulminans triaged to Urgent consultant clinic Other cases generally triaged to Nurse led acne clinic (seen by experienced dermatology nurses) and other treatments recommended or counselled and worked up for Isotretinoin Seen at consultant clinic and isotretinoin initiated Nurse specialist clinic should be established soon • • • 45% patients discharged from acne clinic 25% required Roaccutane immediately and referred to dermatology consultant 30% given treatment advice and review at nurse led clinic Benzoyl Peroxide Azelaic Acid Antibacterials Topical Retinoids Combinations Other agents Acnecide® gel £5.44 / 30g Finacea® Dalacin T® £ 5.08 / 30mls Differin® Gel £11.40 / 45g Epiduo® gel Brasivol® (aluminium oxide brevoxyl® cream £3.30 / 40g Skinoren® Zindaclin® £8.66 / 30g Isotrex® gel £5.94 / 30g Isotrexin® gel Panoxyl® gel/ cream £1.89/ 40g / lotion/ aquagel (adapalene 0.1%, benzoyl peroxide 2.5%) £ 17.91/ 45g (isotretinoin 0.05%, erythromycin 2%) 38.09% in fine particles) Actinac® paste £7.49 / 30g Zineryt® £7.71 / 30mls Stiemycin® £7.69 / 50mls Retin A® cream£5.94 / 30g Aknemycin® gel (tretinoin Nicam® gel Duac® gel Acnisal® lotion 0.025%, erythromycin 4%) £7.05 / 30g (benzoyl peroxide 5%, clindamycin 1%) £9.95 / 25g Quinoderm® (BPO 5%-10% potassium hydroxyquinoline sulphate 0.5% ) £1.30 / 25g Tetracyclines Alternative cyclines Macrolides Other Antibiotics Tetracycline doxycycline Erythromycin Trimethoprim Oxytetracycline Lymecycline Minocycline www.carepathways4gp.org.uk