Texas Children’s Hospital DermatologyDepartment’s Treatment Guidelines:Review and UpdatesAUDREY CHAN MD
ASSISTANT PROFESSOR
DEPARTMENT OF DERMATOLOGY
TEXAS CHILDREN’S HOSPITAL
BAYLOR COLLEGE OF MEDICINE
Rationale for the Referral System:The Numbers
~10,000 board certified dermatologists in US 2017
20 Board Certified Pediatric Dermatologists in Texas
9 Board Certified Pediatric Dermatologists in Houston
The Numbers at TCH
Demand Supply
Approximately 50 new referrals(internal and external) per day.
4 full-time, 2 part-timedermatologists
~1000 new patient requests permonth.
<600 new patient appointmentsper month
Prioritizing acuity
Urgent/Emergent(<1 week): severe pain, impending permanent functionalimpairment or scarring
High Priority (2-6 weeks): severely symptomatic DESPITE guidelines
Priority (<3 months): severely symptomatic WITHOUT GL, psychological distress
Routine(<6 months): everything else…
Triage based on information provided
TCH DERMATOLOGY GUIDELINES
Update: Acne Guidelines
Update: Atopic Dermatitis Guidelines
Update: Impetigo Guidelines
Update: Hypertrophic Scars/KeloidGuidelines
Update: Keratosis Pilaris Guidelines
Update: Molluscum Guidelines
Update: Nevi/Moles Guidelines
Update: Nickel Contact Dermatitis Guidelines
Update: Onychomycosis Guidelines
Update: Psoriasis Guidelines
Consider calling on-call dermatologistfor expedited appointment
Update: Scabies Guidelines
Update: Seborrheic Dermatitis Guidelines
Update: Tinea Capitis Guidelines
Update: Tinea Versicolor
Update: Vascular Birthmark Guidelines
Urgent/Emergent: Ulcerated hemangiomas
Urgent/Emergent: Eyelid hemangiomacompromising vision
Urgent/Emergent: Large segmental facialhemangioma (S3) with airway compromise
Update: Vitiligo Guidelines
Update: Wart Guidelines
NEW TREATMENT GUIDELINES
New: Diaper Dermatitis Guidelines
New: Hidradenitis Suppurativa Guidelines