Atopic Dermatitis — Considerations for Subspecialty Referral — Clinical Pathway: All Settings

Atopic Dermatitis Clinical Pathway — All Settings

Considerations for Subspecialty Referral

Outpatients

Most patients with AD do not need urgent consultation or outpatient referrals to Dermatology or Allergy/Immunology. Consider an expedited referral request to dermatology/allergy for:

  • Severe or refractory disease
  • Unclear diagnosis
  • Suspected food allergy
  • Suspected immunodeficiency

Pediatric Dermatology Referral Request Form (Non-CHOP Providers Only)

Inpatients

  • Consult for severe or refractory disease requiring escalation of treatment
  • Initiation of systemic agents to control disease
  • Severe or recurrent skin infections
  • Concern for underlying immunodeficiency

Referrals

Dermatology Referral
  • Uncertain diagnosis
  • Possibility of:
    • Contact dermatitis
    • Psoriasis
    • Fungal Infection
  • History of recurrent skin infections
  • Extensive/severe disease
  • Management to date has not controlled symptoms
  • Need for Class 1 topical steroid
Allergy Referral
  • Mod/severe atopic dermatitis and known/suspected food allergies
  • Environmental triggers suspected
  • Concomitant moderate or severe asthma
  • Infants with severe atopic dermatitis
Immunology Referral
  • Immunodeficiency or suspected immunodeficiency
  • History of recurrent fractures or infections in older children
  • Infants with severe atopic dermatitis and growth concerns, infections