CUH Pilot Project - Electronic Phototriage of Referrals For Infantile Haemangiomas18 November 2016
Consultant Dermatologists and Consultant Paediatricians at Cork University Hospital announce the launch of a National Pilot for Photo-Triage of Referrals for Haemangiomas from November 1 2016. General Practitioners can email a photograph of the haemangioma together with the child’s date of birth via Healthmail to
Email address: firstname.lastname@example.org Coordinator: Dr Michelle Murphy
A paediatric dermatologist will review the photograph within 5 working days and contact the general practitioner via phone or email with a clear referral pathway dependent on the geographical location of the patient.
Infantile haemangioma of eyelid: pretreatment and 14 days following commencement of treatment. BMJ 2013;346:f1211
The discovery in 2008 of propranolol as an effective treatment for haemangiomas of infancy (IH) has been one of the highlights of paediatric dermatology. (1,2) IH mainly develop between 4 weeks and 3 months of age. There is evidence now that a period of accelerated growth occurs between 5.5 and 7.5 weeks of life and that those treated earlier have more favorable outcomes. (3)
Thus, early haemangiomas need to be recognized more promptly, and infants with high-risk haemangiomas should be referred to specialists urgently for either initiation of treatment or close clinical observation.
In an era of prolonged waiting lists and unprecedented pressures on general practice, consultant dermatologists need to have mechanisms in place for urgent evaluation of infants with high-risk IH, and a triage system for reviewing clinical photographs to determine what is high risk and to optimise timing of consultation and management.
The aim of this project is to provide a fast-track approach for general practitioners to send a photograph of the haemangioma together with the child’s date of birth via Healthmail to a paediatric dermatologist who will review the photograph within 5 working days and contact the general practitioner via phone or email with a clear referral pathway dependent on the geographical location of the patient. The reviewing dermatologist will also contact their counterpart paediatric dermatologist in the relevant geographical location to alert them to the expected referral and pass on any relevant information. The outcomes of the referrals will be collated and documented. The process will be reviewed at six months.
The pilot and email address will advertised to health professionals via HSE communications, ICGP and general publicity.
Leaute-Labreze C, Dumas de la Roque E, Hubiche T, et al. Propranolol for severe hemangiomas of infancy. N Engl J Med. 2008 Jun 12;358(24):2649–51
Léauté-Labrèze C, Hoeger P, Mazereeuw-Hautier J, et al. A randomized, controlled trial of oral propranolol in infantile hemangioma. N Engl J Med. 2015;372(8):735.
Megha M. Tollefson, Ilona J. Frieden. Early Growth of Infantile Hemangiomas: What Parents’ Photographs Tell Us. Pediatrics 2012, 130 (2) e314-e320
Media Release: Strawberry Marks Treatment Improves
Doctors at Cork University Hospital (CUH) have developed a novel photo-triage referral system for babies with “strawberry marks”, a condition that can be life-threatening if untreated, and can lead to long-term facial deformities. Read media release here>