When should I consider referring a patient with discoid eczema to a dermatologist?

Consider referring a patient with discoid eczema to a dermatologist if:

• the diagnosis is uncertain or the presentation is atypical, making it difficult to confirm discoid eczema clinically;
• the eczema is not responding satisfactorily to optimal management, such as persistent flares despite treatment;
• there are significant social or psychological impacts on the patient;
• there is suspicion of contact allergic dermatitis contributing to the eczema;
• the eczema is complicated by severe or recurrent infections;
• specialist advice is needed on treatment application techniques or management strategies.

These criteria are extrapolated from guidance on atopic eczema referral indications, which are applicable to other forms of eczema including discoid eczema, as specific UK guidelines for discoid eczema referral are not separately detailed.