The National Institute for Health and Clinical Excellence (NICE) of the NHS listed indications for when it is appropriate to refer a child with atopic eczema (atopic dermatitis) to a specialist.
Patient selection: pediatric patient with atopic eczema (atopic dermatitis)
Indications for referral to a specialist:
(1) There is uncertainty about the diagnosis.
(2) The dermatitis is not adequately controlled by first-line treatment AND the family has been compliant with the regimen.
(3) The dermatitis involves the face AND it has not responded to appropriate therapy.
(4) The patient or caregiver may benefit from training about management.
(5) Contact allergic dermatitis and/or food allergy is suspected.
(6) The skin disorder is causing significant social and/or psychological problems (disability) for the patient. This may include school performance, social interactions, etc.
(7) The skin disorder is causing significant social and/or psychological problems for a parent.
(8) The dermatitis has been complicated by severe and recurrent infections (deep abscesses, pneumonia, etc).
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