What to expect- dermatology appointment…

[PicklesAndPumpkins1]

I’ve got an initial dermatology appointment in October after being referred recently by my GP for psoriasis, but I’m not actually sure what to expect at it or what will happen. Will it just be a discussion with the dermatologist and I’ll leave with the medication to help my skin? Or is it the type of service whereby you come back for several appointments?

on the letter it says to go to a ‘ward’ in the hospital which has confused me slightly as I thought wards were for people staying in hospital? Or does when the referral letter says ‘ward’ is that just the general name for the dermatology department?

I don’t have any experience with hospitals (thankfully!) so I’m a bit uncertain with it all and I would feel less worried if I knew roughly about what to expect at the appointment.

Is your psoriasis new? I expect the dermatologist will have a look, and if you haven't had any treatment before give you a prescription for some steroid cream or similar, and an appointment to follow up in a few months to see if it's working. If you've already been through various creams with your GP, they could prescribe other drugs or biologics (which will also require follow ups to check progress, I used to take a biologic and had blood tests twice a year to check on me). A treatment that might be offered is light therapy - I haven't had this but I assume that would mean a series of appointments.

It's odd they've called it "ward" rather than "department" but I would assume it's an outpatient department that will function much like a GP surgery

That’s very helpful thanks.

yes it’s new, I have no previous experience seeing a dermatologist at all. Steroid creams from the GP haven’t touched it unfortunately. Hoping it’s just a quick appointment and I can leave with some cream or something simple to help my skin !

Don't worry - it'll be dead straightforward and the word 'ward' is neither here nor there really. It's really good that your GP has referred you to a specialist.

In all likelihood, the dermatologist will take a look at your skin, ask you some questions and then suggest a treatment - that might be a cream that your GP hasn't already tried, perhaps, or it might be another type of medication or treatment, but that will obviously be for the dermatologist to decide and explain to you.

It's possible they might send you for a blood test or take a little skin sample for a biopsy or something, but they might not need to. Chances are it will be a fairly quick appointment and nothing complicated!

You'd then usually have a follow-up appointment so they can see how your skin has responded to whatever treatment they suggested.

Can I ask if you've had psoriasis before or whether this is a new and sudden thing for you? I had a very bad psoriasis outbreak in my 20s that literally just appeared one day in the form of tiny little red, flaky spots all over my body, which then expanded into bigger and bigger patches over time - patches the size of tea-plates. Nothing the GP prescribed helped (they didn't even know was it was at first) but when I was referred to a dermatologist they prescribed me a different type of cream that did help improve it, although ultimately it probably finally went away completely on its own. There are various types of psoriasis and the type I had was probably triggered by a nasty throat infection I'd had a few weeks beforehand that had sent my immune system into overdrive, possibly combined with stress. I'm now in my 40s and I've only ever had one tiny patch on my tummy since then, which went away on its own. So if your situation is similar to this, try not to worry too much: I know it's a horrible thing to have but there is definitely light at the end of the tunnel!

They will take a history, ask about medication and previous treatment. They will also ask about areas affected including nails and whether you have any issues with your joints. They should look at all areas of you skin. Depending on the severity of your disease they might give you topical treatment or refer you for UV treatment. They may ask you to fill in a quality of life assessment. If they are considering systemic medication they will do bloods and a chest x ray.
Whether they will give you a return appointment will depend on disease severity and the treatment. I guess the clinic is in a converted ward and they haven't changed the name. Dermatology beds are very rare so I doubt they will be admitting you.

my OP was very unclear, apologies! I didn’t ever think I would need admitting (I’m in great health, other than this damned psoriasis) but I started wondering what to expect at the appointment and when i saw the word ‘ward’ I was even more confused.

it’s reassuring to know other people have had positive experiences.

what is a biologic? Is it a cream for psoriasis? I’ve tried googling but I can’t make sense of it and have 0 experiences with skin problems. None of the prescribed steroids creams have helped so I was hoping the dermatologist would be a quick ‘in and out’ appointment and I can get a cream that will fix my skin !

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