The NICE guidelines recommend the following criteria for referral for specialist dermatological advice in children:
Immediate same day referral:
- Suspected eczema herpeticum
Urgent referral (within 2 weeks):
- severe atopic eczema that has not responded to optimum topical therapy after 1 week
- failure of bacterially infected eczema to respond to treatment.
Other indications for referral include:
- where the diagnosis is uncertain
- unsatisfactory response to therapy
- unresponsive facial atopic eczema
- where specialist advice is required for treatment application (eg. bandaging)
- suspected allergic contact
- significant consequent social or psychological problems, severe and recurrent infections, especially deep abscesses or pneumonia.
Other referrals may be considered for psychological advice, where food allergy is suspected or where there is associated growth failure.