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Skin Health (SK)

  • Skin conditions account for a significant proportion of consultations across all age groups to General Practice(1). From acute rashes, including viral exanthems and skin infections to more chronic conditions such as eczema, rosacea, acne and psoriasis, general practitioners are often the point of contact for patients with skin concerns. GPs must be confident in recognising a wide range of dermatological presentations, understanding when to treat, when to refer, and how to manage both the clinical and psychological impact of skin disease. GPs are involved in the diagnosis and management of lumps and bumps, solitary and multiple skin lesions, and premalignant lesions. Some GPs have an extended role in skin health where they perform cryotherapy, removal of lesions or Roaccutane prescribing. Skin cancer detection is another crucial area, with GPs playing a key role in early recognition and referral.  With the right skills in observation, diagnosis, and patient education, GPs can manage most skin conditions effectively in the community. This chapter outlines the knowledge and practical competencies needed to deliver safe, evidence-based, and empathetic care in skin health. 

    • SK1. Demonstrate competence in history-taking and examination of dermatological presentations.
    • SK2. Recognise and assess skin-specific signs and presentations differentiating between normal variations and pathological findings.
    • SK3. Manage a broad range of dermatological conditions across various scenarios with safety netting and follow-up.
    • SK4. Prescribe appropriate topical treatments with understanding of formulations and safety.
    • SK5. Recognise when systemic therapy is indicated and coordinate treatment and monitoring.
    • SK6. Adopt a holistic approach addressing physical, emotional, and social impacts.
    • SK7. Consider interplay between skin and systemic illness.
    • SK8. Educate and empower patients in self-management and prevention.
    • SK9. Assess wounds and implement evidence-based management strategies.
    • SK10. Demonstrate ability to perform cryosurgery.
    • SK11. Understand genetic components of common skin conditions.
    • SK12. Be aware of local referral pathways and resources.
    • SK13. Ensure adequate clinical photography for telemedicine and records.
    • SK14. Manage patient data and photographs ethically and legally.
    • SK15. Demonstrate ability to integrate evidence based skin cancer prevention strategies into routine primary care, including risk assessment, patient and carer education on UV protection.

    For each problem or disease, consider the following areas within the general context of primary care:  

    • Natural history of the condition (acute or chronic)
    • Incidence and prevalence across demographics
    • Typical and atypical presentations
    • Recognition of normal variations throughout life
    • Risk factors, including lifestyle, socio-economic and genetic factors  
    • Diagnostic features and differential diagnosis
    • Recognition of ‘alarm’ or ‘red flag’ features  
    • Appropriate and relevant investigations  
    • Interpretation of test results
    • Management including initial and continuing care, chronic disease monitoring and emergency care  
    • Patient and carer information and education   
    • Prognosis

    Signs, Symptoms & Presentations

    • Birthmarks
    • Blisters
    • Boils
    • Changes in pigmentation
    • Dry Skin
    • Eruptions
    • Erythema
    • Hairloss
    • Hirsutism
    • Hyperhidrosis
    • Lichenification
    • Nail dystrophies
    • Nail discolorations
    • Petechiae
    • Purpura
    • Pustules
    • Rashes
    • Skin Lesions
    • Ulceration including leg ulcers and pressure sores  

    Common and Important Conditions

    • Acne Rosacea
    • Acne Vulgaris
    • Basal Cell Carcinoma
    • Blistering Diseases
    • Cysts
    • Drug Eruptions
    • Eczema (infantile, childhood, atopic, seborrheic, contact allergic, irritant, discoid, varicose, asteatotic) 
    • Erythroderma
    • Fungal, Bacterial and Viral Infections
    • Hair disorders (alopecia, hirsutism, fungal infection, infestations) 
    • Hidradenitis Suppurativa
    • Hyperpigmentation (Acanthosis Nigricans)
    • Hypopigmentation (Vitiligo)
    • Insect Bites and Infestations
    • Melanoma
    • Onychocryptosis
    • Onychomycosis
    • Paronychia
    • Perioral Dermatitis
    • Pityriasis Rosea
    • Pityriasis Versicolor
    • Psoriasis
    • Seborrheic Keratosis
    • Squamous Cell Carcinoma
    • Staphylococcal Scalded Skin Syndrome
    • Stevens-Johnson Syndrome
    • Systemic Lupus Erythematosus
    • Toxic Epidermal Necrolysis
    • Ulcers
    • Vasculitic and Autoimmune Conditions
    • Warts

  • Wherever possible learning resources included here are peer reviewed and externally maintained. This is to ensure that trainees have access to quality assured information that is kept up to date.

    Self-Directed 

    Blended Learning Resources (Education Platform)

    Dermatology in GP - a focus on acne

    Dermatology in GP - A Focus on Psoriasis and Eczema

    Useful Websites

    Irish Skin

    Dermatology Information System

    Dermnet

    British Association of Dermatologists

    Primary Care Dermatology Society Ireland

    Cunliffe General Dermatology Diagnostic Tool

    Dermabuddy App

    Antibiotic Prescribing Guidelines

    British Association for Paediatric and Adolescent Dermatology

    Melanoma Referral Guidelines

    Textbook: Textbook of Primary Care Dermatology by David Buckley and Paola Pasquali

    Workplace Based Learning

    Workplace-based learning is essential for developing practical confidence in dermatology. In both general practice and hospital settings, you’ll encounter a wide variety of skin presentations; some straightforward, others more complex or subtle. These experiences help sharpen your clinical observation skills, improve lesion recognition, and build confidence in diagnosing and managing common conditions such as dermatitis, fungal infections, acne, and urticaria. Hospital dermatology clinics or minor ops lists, if available, provide further exposure to more complex or surgically managed skin diseases, including skin cancers.

    Day Release

    Day release sessions are a great opportunity to enhance your knowledge of dermatology in a collaborative and reflective setting. Case-based discussions allow trainees to explore diagnostic reasoning, management strategies, and referral criteria for a range of skin conditions, including common childhood rashes, eczema management, and lesion assessment. Learning from peers’ experiences across different practices broadens your exposure and builds your ability to manage skin problems confidently and appropriately in primary care.

    Registrar Tutorials

    Registrar tutorials offer a focused setting to develop skills in skin health tailored to your clinical needs and recent cases. These sessions are ideal for reviewing photos of skin lesions or rashes you've seen in practice, discussing differential diagnoses, and exploring management options with your trainer. You can practise describing lesions accurately, applying the ABCDE criteria for melanoma screening, or reviewing treatment plans for chronic conditions like acne, psoriasis, or atopic eczema. Tutorials also provide a safe space to reflect on diagnostic uncertainty, consider patient concerns, and reinforce safe prescribing practices for dermatological medications, such as topical steroids or isotretinoin.

  • Entrustable Professional Activities (EPAs) underpin workplace-based assessment in this curriculum. Each EPA represents an integrated clinical task that General Practitioners must perform safely and independently, assessed through direct or indirect observation in real clinical settings.

    The curriculum and EPA framework are closely aligned: the curriculum defines the required knowledge, skills, and professional behaviours, while EPAs assess their application in practice. Together, they create a coherent approach to developing and demonstrating readiness for independent clinical work.

    The examples show how specific activities within general practice & chapters of the curriculum align with particular EPAs.

     EPA 11: Manage the health promotion and preventive health needs of adults, including older people

    When providing education about sun protection, wound care, and prevention of skin cancer, trainees demonstrate EPA 11 by integrating health promotion, patient empowerment, and care tailored to individual risk factors.

    Core Knowledge Test (CKT)

    • Diagnosis of Melanoma

    • Management of Eczema

    • Management of Acne Vulgaris

    Clinical Competency Test (CCT)

    • A patient presenting with an itchy rash on their hands.
    • A patient presenting with acne.
    • A patient presenting with a pigmented lesion.

    Disclaimer: The examples provided within this section are intended to be indicative only and are included to illustrate how elements of the curriculum may be assessed in the Clinical Competency Test (CCT).

    Examination questions in the CCT test the ability of candidates to integrate knowledge, skills, and professional behaviours across multiple curriculum areas to address the challenges posed by the question.

    The indicative content should therefore be used solely as a general guide as to some of the topics that may be introduced. Actual examination questions will assess a greater depth and complexity of understanding than the illustrative examples provided.

    Please note that a number of CCT questions will require candidates to undertake a physical examination of the simulated patient. In some circumstances, for example in the case of an intimate examination, candidates may be required to display their examination skills through use of a manikin or other device.

  • 1. Dermatology in primary care: Prevalence and patient disposition. ResearchGate [Internet]. 2025 Aug 5 [cited 2025 Aug 19]; Available from: https://www.researchgate.net/publication/11878410_Dermatology_in_primary_care_Prevalence_and_patient_disposition