From Dr R. Woodford, MRPharmS
SIR,—The interesting report (PJ, January 1, p8) of the recent meeting of the All Party Parliamentary Group on Skin (APPG) highlighted the popularity of general practitioner consultations for skin complaints, possible deficiencies in medical education in dermatology, "significant unmet needs" in primary care and the need for greater involvement of pharmacists.
During the past five years the subject of dermatological education in primary care has been addressed,1 and a core curriculum was recently produced jointly by the Royal College of General Practitioners, the British Association of Dermatologists and the Royal College of Physicians. Among the recommendations of a March, 1997, APPG report was one to educate patients in the responsible use of primary care resources - and perhaps that is where we enter the picture.
Everyone knows that members of the public with skin complaints visit community pharmacists, but there is lack of detailed information in that area. With this in mind, a study was made of every person presenting to the pharmacist in a village community pharmacy with a dermatological condition or inquiry over an 18-month period. Patients made return visits, if required. The results were analysed using the criteria: month of consultation, sex and age of patient, perceived symptom or other reason for consultation, number of return visits per patient and duration of consultation. There were 1,051 total consultations (714 initial and 337 return visits).
That study2 was presented by invitation to both regional (Wessex Primary Care Research Network) and national (Primary Care Dermatology Society) meetings of medical practitioners. Such work should demonstrate the value of community pharmacists in partially satisfying the APPG's recommendations.
In the above study, consultations ranged from the vaguely intriguing ("all the people in the house keep scratching") to the undoubtedly obscure (a possible case of granuloma annulare in a diabetic) to the downright interesting (two young ladies who were spending a hot, sunny week at the local nudist camp).
Roger Woodford
Farlington, Hampshire