Curriculum standards
Curriculum standards
Completion requirements
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Advanced Training in Dermatology
Knowledge guides
LG12: Medical dermatology
Key presentations and conditions
Advanced Trainees will have a comprehensive depth of knowledge of these presentations and conditions.
Less common or more complex presentations and conditions
Advanced Trainees will understand these presentations and conditions.
Advanced Trainees will understand the resources that should be used to help manage patients with these presentations and conditions.
Epidemiology, pathophysiology, and clinical sciences
Advanced Trainees will have a comprehensive depth of knowledge of the principles of the foundational sciences.
Investigations, procedures, and clinical assessment tools
Advanced Trainees will know the scientific foundation of each investigation and procedure, including relevant anatomy and physiology. They will be able to interpret the reported results of each investigation or procedure.
Advanced Trainees will know how to explain the investigation or procedure to patients, families, and carers, and be able to explain procedural risk and obtain informed consent where applicable.
Important specific issues
Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management and integrate these into care.
Presentations
- Acne excorie
- Angioedema
- Blisters
- Eruption:
- blistering
- drug
- eczematous
- pustular
- Erythematous papules / patches / plaques
- Erythroderma
- Facial flushing
-
Hair:
- excessive growth
- loss
- Indurated plaques
- Itch
- Lesion of concern
-
Nail:
- bed inflammation
- discolouration
- plate changes
- Pigmentary changes
- Scarring
- Skin:
- failure
- injury
- Ulceration:
- mucous membranes
- oral
- Urticaria
Conditions
- Angioedema and urticaria
- Connective tissue diseases and collagen vascular disorders:
- dermatomyositis
- lichen sclerosus
- localised forms of scleroderma
- lupus erythematosus
- morphoea
- panniculitis:
- lobular
- septal
- systemic sclerosis
- vasculitis
- Contact dermatitis:
- allergic
- irritant
- non-eczematous contact dermatoses
- occupational skin dermatoses
- photoallergic and phototoxic
- Cutaneous manifestations in the immunosuppressed host / graft-versus-host disease
- Dermis disorders:
- eosinophilic disorders
- histiocytoses
- mastocytoses
- neutrophilic dermatoses
- Genital and mucosal conditions
-
Immunobullous disease, including, but not limited to:
- bullous pemphigoid
- cicatricial pemphigoid
- linear IgA dermatoses
- pemphigus
-
Infiltration disorders:
- acneiform conditions
- disorders of cornification
- granulomatous processes:
- lichenoid eruptions
-
Inflammatory dermatoses:
- dermatitis (all types)
- psoriasis
- Pigmentation disorders, such as:
- vitiligo
Conditions – drug eruptions
- Drug eruptions, such as:
- fixed drug eruption
- generalised drug eruption
- lichenoid
- severe cutaneous adverse reactions
Conditions – hair and nail
-
Alopecia:
- non-scarring
- scarring
- Chromonychia
- Congenital and inherited nail diseases
- Cutaneous manifestations of internal malignancy
- Hair loss, caused by drugs
- Hirsutism
- Hypertrichosis
- Inflammatory conditions affecting the nails
- Systemic conditions presenting with nail and hair symptoms
- Vitamin deficiencies
Conditions – hypersensitivity reactions
-
Allergy / Sensitisation:
- environmental
- food
- Scar:
- atrophic
- hypertrophic
- keloid
Conditions – skin of colour
- Dermatological issues for patients with skin of colour, such as:
-
follicular disorders, such as:
- acne keloidalis nuchae
- comedonal acne
-
pigmentary disorders, such as:
- melasma
- pityriasis alba
- vitiligo
-
follicular disorders, such as:
- Variants of conditions in skin of colour, such as:
- annular and hypertrophic lichen planus
- hypopigmented mycosis fungoides
- nummular and follicular dermatitis
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigation
- consider the impact of illness and disease on patients and families, and their quality of life
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
Presentations
- Drug eruption in complex medical patients, such as those:
- in the intensive care unit
- who are oncology patients
- with immunodeficiency
- Hair shaft changes
Conditions
- Dermatological diseases:
- genital
- Oral mucosal premalignant and malignant disease, such as mammary and extramammary Paget disease
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigation
- consider the impact of illness and disease on patients and families, and their quality of life
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
Genital and mucosal
- Anatomy and physiology of normal female and male anogenital regions and mucous membranes
- Anogenital region diseases, such as:
-
dermatoses:
- benign
- malignant
- inflammatory diseases
- sexually transmitted infections (STIs)
- skin lesions:
- benign
- malignant
-
dermatoses:
Hair and nail
- Hair follicle:
- anatomy and development
- microscopic structure
- Nail anatomy and biology
Inflammation
- Cellular and molecular biology of inflammation, including:
- adhesion molecules
- arachidonic acid metabolism
- basophils and eosinophils
- complement system
- cytokines
- human leukocyte antigen system
- immunoglobulin structure and function
- polymorphonuclear leukocytes
- Immunology in relationship to the skin
- Pathology results, including relevant blood and serology tests related to autoimmune diseases and systemic diseases with cutaneous manifestations
-
Principles of:
- contact dermatitis
- different forms of urticaria
- drug allergy and patch testing
- wound healing and scar formation
Clinical assessment tools
- Clinical assessment tools, such as:
- Dermatology Life Quality Index (DLQI)
Procedures
- Botulinum toxin for hyperhidrosis
- Iontophoresis
- Triamcinolone injection
Investigations
- Bacterial and viral swabs for culture and/or polymerase chain reaction (PCR)
- Blood tests
- Dermoscopy, including:
- digital dermoscopy
- Hair sampling for histological analysis
- Histopathology
- Patch testing, including:
- ability to select appropriate batteries of allergens based on history and examination findings
- knowledge of:
- Aotearoa New Zealand core series
- Aotearoa New Zealand extended series
- specific extended series
- Photography
- Phototesting, including:
- monochromator
- photopatch
- photoprovocation
- Radiographic imaging
- Scraping and nail clipping for mycology
- Skin biopsy, including:
- immunohistochemistry
- immunofluorescence
- Trichoscopy
- Wood’s lamp
- Management of a cutaneous disease in complex comorbid patients in intensive care
Genital and mucosal
- Patient confidentiality issues
Immunodermatology
- Psychological impact, both short- and long-term, of severe drug reactions and other dermatological diseases
- Safety of desensitisation techniques
- Techniques in desensitisation
Occupational dermatology
- Allergen avoidance, advanced management of occupational dermatitis, and prevention of skin disease
- Details of function of and occupational exposure to common allergens in extended patch test series, such as hairdressing battery
- Medical reporting
- Medicolegal aspects of contact dermatitis, including Accident Compensation Corporation (ACC) legislation and reporting
- Workplace assessments
Psychodermatology
- Clinical features, assessment, investigation, and management of primary psychiatric disease presenting as skin disease to dermatology
- Clinical features, assessment, investigation, and management of primary skin disease presenting with psychosocial comorbidity
- Dermatological manifestations of psychological problems
- Drug- or toxin-induced psychiatric or psychological conditions
-
Features of:
- anxiety
- depression
- risk factors for suicide
-
Multidisciplinary approach to primary psychiatric disorders:
-
psychiatric conditions that result in self-induced skin conditions, such as:
- delusions of parasitosis
- trichotillomania
-
psychiatric conditions that result in self-induced skin conditions, such as:
- Psychiatric differential diagnosis in skin disease
-
Psychophysiological disorders:
- skin problems that are not directly connected to the mind but react with emotional states, such as eczema and psoriasis
- Psychosocial impact of dermatological disease, including, but not limited to:
- genital and mucosal dermatological disease
-
Secondary psychiatric conditions:
-
associated with disfiguring skin disorders that can cause depression or social phobia, such as:
- cystic acne
- psoriasis
-
associated with disfiguring skin disorders that can cause depression or social phobia, such as:
Skin of colour
- Understand the differences required in treatment plans when treating skin of colour:
- increased risk of post-inflammatory hyperpigmentation and hypertrophic scarring
-
recognise sociocultural barriers to:
- accessing health care
- interactions
- treatment
-
understanding that varied cultural practices may be undertaken by patients to treat skin conditions, including:
- acupuncture
- ayurvedic medicine
- mirimiri
- karakia / prayer
- rongoa
PCH
- Age- and patient-appropriate techniques for skin biopsies and other painful procedures
- Age-appropriate assessment tools to assess quality of life
- Association between childhood eczema and other atopic disorders, and the importance of developing immune tolerance
- Differences in presentation of inflammatory skin disorders in children and adolescents compared to adults
- Incidence and prevalence of inflammatory skin disorders in childhood and adolescence