Developing dermatology in primary care

Dr Finbar Fitzpatrick of the Primary Care Dermatology Society of Ireland speaks to the Medical Independent about the Society’s upcoming annual meeting

The Primary Care Dermatology Society of Ireland (PCDSI) Annual Scientific Meeting 2023 will take place at the Newpark Hotel, Kilkenny on 3-4 March. It will be the Society’s first in-person annual meeting since 2020 due to the Covid-19 pandemic.

Dr Finbar Fitzpatrick, PCDSI Treasurer and committee member, told the Medical Independent (MI) that the Society held online meetings in 2021 and 2022. However, the return of an in-person meeting would best facilitate the “human social interaction aspect” and the exchange of “ideas and experiences which you don’t get as much on an online forum”.

The two-day meeting will feature dermoscopy courses and presentations on topical issues in dermatology delivered by national and international experts. The expansive programme, which will principally cater for GPs with an early or advanced interest in dermatology, has been put together by Dr Johnny Loughnane of the PCDSI. About 400 delegates are expected to attend. Registration is open to PCDSI members and non-members. There are reduced rates for members and for those who register in advance online.

Experts in dermoscopy

According to Dr Fitzpatrick, a number of world-renowned experts in their fields will be presenting during the meeting.

He said Prof Giuseppe Argenziano from Italy and Prof Aimilios Lallas from Greece, for example, “are both world-renowned for driving dermoscopy since its inception as a tool for looking at pigmented and non-pigmented skin lesions and skin cancers. They are experts in their field so we are very lucky to have them speaking; they will be in high demand.” Prof Argenziano and Prof Lallas will join the meeting via video-link and all other speakers will be in-person.

“Dr [Jonathan] Bowling from the UK is another world-renowned expert and locally we have Dr [Kashif] Ahmed who is going to Chair the [advanced dermoscopy] meeting – he is a Consultant Dermatologist in Limerick.”

Dr Andreas Blum from Austria will be another renowned dermoscopy expert speaking at the meeting, while the contribution of Dr Jerry Tan from Canada is also eagerly anticipated, according to Dr Fitzpatrick. The meeting will include question and answer sections and an opportunity to network with speakers and colleagues.  

Topics in the opening advanced dermoscopy session include acral melanoma (Dr Jonathan Bowling, Consultant Dermatologist, Dermoscopy UK Ltd); white lesions and white structures (Prof Aimilios Lallas, Associate Professor of Dermatology, First Department of Dermatology, Aristotle University, Greece); and red lesions (Prof Giuseppe Argenziano, Full Professor and Head, Dermatology Unit, University of Campania, Italy).

The parallel session, on basic dermoscopy, includes presentations on how dermoscopy works and practical tips (Dr Chin Whybrew, GP, UK, and Primary Care Dermatology Society (PCDS) UK Dermoscopy Lead); interpreting dermoscopic structures, seborrhoeic keratosis, warts and haemangiomas (Ms Julie Van Onselen, Dermatology Practitioner Lecturer/Clinical Nurse Specialist, PCDS); and dermatofibromas, sebaceous hyperplasia and comedones (Dr Julian Peace, GP, Specialty Doctor in Dermatology at Barnsley NHS Foundation Trust and PCDS).

The mid-morning advanced dermoscopy session will feature the following topics: Collision lesions (Prof Andreas Blum, Public, Private, and Teaching Practice of Dermatology, Germany); mucous membranes (Prof Aimilios Lallas); and difficult seborrhoeic keratoses (Dr Jonathan Bowling).

The mid-morning basic dermoscopy session will cover benign naevi (Dr Chin Whybrew); basal cell carcinoma (Ms Julie Van Onselen); and actinic keratosis, Bowen’s, squamous cell carcinoma, keratoacanthoma (Dr Julian Peace).

The advanced dermoscopy session in the afternoon will feature tips for the more experienced dermoscopist, delivered by Prof Giuseppe Argenziano; and a presentation titled ‘Chameleon melanoma – variability of melanoma’ by Prof Andreas Blum. Melanomas will be among the topics covered in the afternoon’s basic dermoscopy session.

Evening session

The evening session is open to all delegates who are registered for either day. It will include presentations on how lupus and other connective tissue diseases can manifest in the skin (Prof Mark Davis, Consultant Dermatologist, Mayo Clinic, US); an overview of the cutaneous manifestations of the other connective tissue diseases other than lupus erythematosus (Dr Eoin Storan, Consultant Dermatologist, Mater Misericordiae University Hospital, Dublin); diagnosing normal and abnormal findings in the mouth (Prof Mark Davis); and common cutaneous manifestations of systemic disease (Dr Eoin Storan). The conference dinner, which is open to all delegates, will take place on Friday evening.

Second day

Throughout Saturday an advanced symposium will be held on acne and rosacea. An introduction to the area will be provided by Prof Sarah Rogers, Clinical Professor of Dermatology, University College Dublin. Prof Alison Layton, Consultant Dermatologist and Associate Medical Director for Research and Development, Harrogate and District NHS Foundation, UK, will speak on managing acne with hormonal treatments.

Dr Maeve Durkan, Consultant Endocrinologist, The Cork Clinic/Bon Secours Hospital, Cork, will present on polycystic ovary syndrome; while Dr Muriel Sadlier, Consultant Dermatologist, University Hospital Limerick, will offer practical treatment tips to maximise adherence to topical acne treatment and discuss evidence-based dietary interventions for acne. Prof Alison Layton will present on ‘New concepts, concerns and creations in acne’.

The parallel basic symposium on Saturday morning will focus on general dermatology for everyday practice. Dr Conor Brosnan, GP, and Dr Christopher Bower, Consultant Dermatologist, Royal Devon and Exeter NHS Trust Hospital, UK, will present on nail disorders; Prof Anthony Bewley, Barts Health NHS Trust, UK, will discuss psychodermatology; and Dr Charles Colin Long, Consultant Dermatologist, Cardiff and Vale NHS Trust, UK, will advise on how to avoid common dermatological pitfalls. In a joint presentation, Dr Brian Malcolm, GP Principal and trainer and Associate Specialist Dermatologist, North Devon and Exeter, UK, and Dr Christopher Bower will share some of the fascinating cases they have encountered in a combined half-century of working in dermatology in their region of the UK.

The mid-morning advanced symposium will have a particular focus on isotretinoin.

‘Isotretinoin dosing, lab monitoring, and structured follow up’ will be the subject of a talk by Prof Megha Tollefson, Consultant Paediatric Dermatologist, Mayo Clinic, US; while Dr Jerry Tan, Consultant Dermatologist, Western University, Canada, will present on acne fulminans and isotretinoin flaring. Minor side-effects associated with isotretinoin will be discussed by Dr Johnny Loughnane of the PCDSI, while major side-effects will be covered by Prof Megha Tollefson.

The medico-legal aspects of prescribing isotretinoin in general practice will be the focus of a presentation by Dr Mary Davin-Power, Senior Clinical Risk Advisor, Medisec Ireland.

The parallel mid-morning basic session on general dermatology will include presentations on skin cancer prevention (Prof Fergal Moloney, Consultant Dermatologist, Mater Misericordiae University Hospital, Dublin); a systematic approach to diagnosis in dermatology (Dr Brian Malcolm); psoriasis – getting good results with primary care management (Dr David Buckley, Founder and Medical Director, Kerry Skin Clinic); and practical advice on wound care (Ms Sheila Ryan, Advanced Nurse Practitioner in Dermatology, University Hospital Limerick).

The afternoon advanced symposium will open with a talk on managing rosacea by Dr Síona Ní Raghallaigh, Consultant Dermatologist, Beaumont Hospital, Dublin, and Bon Secours Hospital, Dublin.

Prof Anthony Bewley will discuss acne and rosacea and the psyche; while Dr Jerry Tan will cover acne scarring and hyperpigmentation.

Dr Síona Ní Raghallaigh will deliver another presentation titled ‘Not acne, not rosacea – so why do I have a red, spotty face?’.

The basic session on general dermatology for everyday practice will outline tips for skin cancer diagnosis (Prof Fergal Moloney) and what is new in skin infections (Dr Alana Durack, Consultant Dermatologist, University Hospital Waterford).

‘Paediatric dermatology – what’s new and useful in primary care’ will be discussed by Dr Cathal O’Connor, Specialist Registrar in Dermatology who is undertaking dual training in general paediatrics. Dr Tríona Hussey, HCA Healthcare, will present interesting dermatological cases from primary care and learning outcomes.