When should I consider referring a patient with ichthyosis to a dermatologist for further evaluation?

Consider referring a patient with ichthyosis to a dermatologist for further evaluation if:

• There is diagnostic uncertainty about the skin condition.
• The ichthyosis is severe, extensive, or atypical in presentation.
• The condition is not responding to optimal management in primary care.
• There are significant impacts on the patient's physical, psychological, or social wellbeing.
• There are complications such as recurrent infections or other systemic symptoms.

Although the provided guidelines do not specifically address ichthyosis, these referral principles align with general dermatology referral criteria for complex or severe skin conditions, as outlined for other chronic dermatological diseases like atopic eczema and psoriasis NICE CG57,NICE CG153.