Dermatology is the study and treatment of a wide range of skin conditions, from minor but irritating conditions like fungal infections, to serious conditions such as skin cancer.
Our dermatology team provide care for adults and children with skin conditions. We also provide a range of specialist clinics.
Please note, our team are unable to give clinical advice without a consultation — please visit your GP.
We are a leading specialised tertiary centre for the care of patients with connective tissue diseases (CTDs).
CTDs are a group of inflammatory autoimmune conditions that can affect the skin, along with other connective tissues such as joints and internal organs.
We care for patients with a variety of CTDs including lupus, morphoea, system sclerosis, dermatomyositis, overlap CTDs and Raynaud's phenomenon.
In addition to weekly dermatology CTD clinics, our specialised multidisciplinary team provides twice-monthly unique combined care alongside our rheumatology colleagues, to ensure seamless care. This means our patients can avoid multiple separate appointments.
Our clinics are also supported by an experienced CTD nurse who assists in providing additional patient education and support.
The CTD clinic is in the Institute of Immunity and Transplantation on the 2nd floor of the Royal Free Hospital. The institute is dedicated to research and clinical care for immune-related disorders.
The location means patients have blood tests and other specialised CTD-related investigations (such as thermography and capillaroscopy) at the same time as their clinic appointment.
In addition, our patients frequently undergo intravenous treatments such as pulsed methylprednisolone or intravenous immunoglobulin at our planned investigation and treatment unit (PITU), which is adjacent to the institute.
Visiting the CTD service
At your first appointment, you will be asked to fill out a new patient questionnaire so we can understand the impact that your condition/CTD is having in all aspects of life.
This enables us to not only treat the medical side of the condition, but also the life impact.
Our patients will also have their heart rate, blood pressure, and urine tested.
A variety of treatments are available for CTDs, from creams to highly specialised intravenous therapies.
The dermatology CTD service is involved in clinical and basic scientific research.
Our research focuses on investigating:
- underlying causes of CTDs
- the impact of related skin disease
- new treatments
All our research ultimately aims to improve the care we can provide and the treatment outcomes for our patients.
If you are seen in our service, we may approach you to take part in our research, if it is relevant to your diagnosis or treatment.
Participation is voluntary and you are under no obligation to take part. You can ask us about our current research at any time.
In addition to our regular CTD clinics, we also support the trust’s scleroderma unit, working very closely with our rheumatology colleagues.
This means patients with skin concerns related (or unrelated) to their CTD are seen by the rheumatologists, and can also be seen by one of the dermatologists in the same visit.
A consultant dermatologist with specialist CTD expertise is available for inpatient/PITU admission consultations and is at the rheumatology scleroderma clinics on a weekly basis.
Living with a skin condition can have a significant impact on quality of life and emotional wellbeing. Our aim is to not only treat your skin, but to help you lead the life you want to.
We work under the principle that psychological wellbeing is at the forefront of medical care for our patients.
Psychological factors such as stress can influence many skin disorders. Having a skin disorder can also affect your mood and behaviour.
Psychological treatment can be helpful in both coping with and treating many skin disorders, either alone or in combination with conventional medications.
Your dermatologist or specialist dermatology nurse can refer you to the psychodermatology service.
You will be assessed within four weeks, but may then need to wait to start a course of treatment.
Once the psychodermatology service has received a referral letter from your dermatologist or dermatology nurse, we will call you to offer an appointment.
Skin cancer treatment
Minor operation facilities are provided at our dermatology clinic for the removal of lesions. Patients with confirmed or suspected skin cancer are given rapid access and treatment.
We aim to treat your psoriasis — a skin condition that causes flaky patches of skin which form scales — and help you lead the life you want to. We work under the principle that every patient is an individual with their own needs and wishes.
You may be asked to have some fasting blood tests performed before your appointment and fill in several questionnaires.
Your appointment will be up to 30 minutes in duration. The clinic nurse will take your weight, blood pressure and urine prior to seeing the doctor. The doctor will ask you questions about your psoriasis, your medical history and examine your skin.
If a prescription is issued, you will take this to the Royal Free Hospital pharmacy on the ground floor (next to Marks & Spencer). The prescription is not valid in pharmacies outside our hospital.
We have a number of psoriasis clinics, including:
- psoriasis step-down
- nurse-led psoriasis
- joint psoriasis and psoriatic arthritis
- psoriatic arthritis
There are many effective treatments available for psoriasis, and we will endeavour to find a treatment that works for you and your lifestyle.
Treatments can be broadly categorised into topical treatments (creams/ointments), phototherapy, systemic medications (tablets) and biological therapies (injections).
Often a combination of these treatments will be recommended. It is useful to think of a treatment pyramid, where most people with psoriasis will be on topical treatments and fewer will require systemic or biological therapy.
Teledermatology is the use of medical photography to diagnose dermatological conditions.
We provide a service for patients based within the London boroughs of Barnet and Enfield.
The service provides an early appointment for patients with the aim of being able to start treatment quickly for those who need it.
If you are an Enfield or Barnet patient, your GP will refer you to the teledermatology service if they feel it is appropriate for you.
You are then offered an appointment with a medical photographer to have a high-quality photograph taken of your skin condition. Our clinics are on different sites — you can choose the location most convenient for you.
The doctor will then assess the image and will either:
- write to your GP with a treatment plan
- invite you to clinic for a face-to-face consultation
- invite you for further treatment (eg excision or biopsy of skin lesion)