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Implementing the Acne Care Pathway

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Presentation on theme: "Implementing the Acne Care Pathway"— Presentation transcript:

1 Implementing the Acne Care Pathway
Dr Art O’Hagan, Consultant Dermatologist

2 Skin disease in the UK 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.

3 Rationalisation of Dermatology services in SHSCT


5 Rationale for care pathways
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.

6 Acne referral data Jan 2012

7 Current Acne clinic in SHSCT
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

8 Summary of Recent audit of acne clinic in Craigavon Hospital
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

9 Inflammatory acne

10 Comodomal acne

11 Commedomal acne

12 Moderate Acne – papules and pustules
Moderate disease papules and pustules

13 Severe Acne – nodules and cysts
Severe presentation with nodules and cysts

14 Need to examine patients as disease is not only confined to facial areas

15 Severe Acne (fulminans)


17 Acne: Excoriation (acne excoriee)

18 Summary of topical therapies for acne
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 (adapalene 0.1%, benzoyl peroxide 2.5%) £ 17.91/ 45g Brasivol® (aluminium oxide 38.09% in fine particles) brevoxyl® cream £3.30 / 40g Skinoren® Zindaclin® £8.66 / 30g Isotrex® gel £5.94 / 30g Isotrexin® gel (isotretinoin 0.05%, erythromycin 2%) £7.49 / 30g Actinac® paste Panoxyl® gel/ cream £1.89/ 40g / lotion/ aquagel Zineryt® £7.71 / 30mls Retin A® cream£5.94 / 30g Aknemycin® gel (tretinoin 0.025%, erythromycin 4%) £7.05 / 30g Nicam® gel Stiemycin® £7.69 / 50mls Duac® gel (benzoyl peroxide 5%, clindamycin 1%) £9.95 / 25g Acnisal® lotion Quinoderm® (BPO 5%-10% potassium hydroxyquinoline sulphate 0.5% ) £1.30 / 25g

19 Oral Antibiotic therapy for acne
Tetracyclines Alternative cyclines Macrolides Other Antibiotics Tetracycline doxycycline Erythromycin Trimethoprim Oxytetracycline Lymecycline Minocycline



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