Expert ‘shocked’ dermatologist prescribed adult drug for boy

An expert in skin conditions has told a medical hearing he was “a bit shocked” to learn another consultant dermatologist had prescribed a medication, normally given to adults only, to an 11-year-old boy.

The evidence was heard at the second day of a Medical Council inquiry into allegations of professional misconduct and poor professional performance against Dr Adam Jacobus Smith of the Whitfield Clinic, Waterford.

The council convened the hearing on foot of a complaint from the Munster Dermatology Group, some of whose members treated 12 patients who had already come under the care of Dr Smith.

The hearing in Waterford was told yesterday that in 2008, Dr Smith treated an 11-year-old boy with psoriasis on his hands and feet and prescribed him Neotigason, described as “inappropriate” for children.

The medicine was “not recommended” for children because of possible side-effects, consultant Dr Con Buckley said yesterday, and was not recommended in cases of “limited psoriasis”, which was what the 11-year-old boy had.

“I was a bit shocked by his treatment approach,” he said in relation to Dr Smith’s prescription of Neotigason.

The use of the drug was “inappropriate” in this case, he said.

The patient’s mother told the hearing her son now followed a regime of “moisturise, moisturise, moisturise”, as recommended by Dr Buckley during subsequent appointments.

One of the allegations against Dr Smith was that he failed to diagnose certain conditions in some patients.

On Wednesday, his barrister, Gabriel Gavigan said one of the patients was found to have vesicular tinea corporis, commonly known as ringworm, when some blisters showed up after Dr Smith saw the patient.

Another patient, who was 17 when he saw Dr Smith in 2008, asked him if using sunbeds would help his psoriasis. Dr Smith told him sunbeds could be “unsafe” but he could use them twice a week, for two weeks, and not return after that.

Dr Buckley told the inquiry he found it “extraordinary” that a dermatologist would “condone” the use of sunbeds, which were linked with skin cancer, to help any condition. “Five minutes on a sunbed is the equivalent of 30 minutes at midday in midsummer on the Mediterranean.

The hearing continues.

* Mr Gavigan has asked us to point out that he did not say bullous pemphigoid was known as ringworm, as was reported in yesterday’s newspaper.