There are many threads by potential recruits on skin disorders, this post is mostly a copy of JSP 346. (some footnotes missing, but will be edited in later) Things to note. The grading of 'P8' basically means 'unfit for any form of military service', the full explanation of medical grading will be coming to a thread near you soon. P2 is fully fit. [align=center]CHAPTER 3: THE INFLUENCE OF PARTICULAR CONDITIONS ON PULHHEEMS ASSESSMENT FOR ENTRY Leaflet 10: SKIN DISEASES[/align] General 3.10.1. When assessing a candidateâs fitness for entry, the potential for ilitary service to either cause or aggravate existing skin disease must be valuated. Chronic skin disease may require frequent and extensive periods of treatment during which the individual would not be fit for unrestricted service. Consideration should be given to skin disease interfering with the wearing of any military equipment. Further restrictions may be dependent on the individualâs intended service or trade, in which case guidelines are available in single-service publications or opinion should be sought from the single Service occupational physician responsible for the selection of recruits. Acne 3.10.2. Candidates with severe acne or involvement of the face, neck, shoulders, chest or back such that it would interfere with wearing military clothing or equipment should normally be graded P8, or entry should be deferred until the disease has been successfully treated. Candidates under treatment with Isotretinoin may be graded P2 eight weeks after completing successful treatment by which time most adverse effects have settled. Dermatitis 3.10.3. Active dermatitis is incompatible with Service life. Therefore, candidates with active atopic or contact dermatitis should normally be graded P8. 3.10.4. Atopic dermatitis. Conditions diagnosed as eczema should also be included in this category. A history of atopic dermatitis is considered to increase the likelihood of irritant contact dermatitis on exposure to irritants (such as oils, greases, detergents) but usually only if the condition was severe in childhood and particularly if it involved the hands. Candidates with a history of atopic dermatitis within the last 3 years should normally be graded P8. For candidates who have been symptom free for over 3 years, the presence of the following risk factors should be considered: a. Functional impairment. b. Dermatitis of the hand(s). c. Secondary care involvement. If none of the above factors are present, the candidate may be graded P2. If any of the above is present, the candidate should be referred to the single Service consultant occupational physician responsible for recruit selection for more detailed consideration. 3.10.5. Irritant Contact Dermatitis. All service personnel may be called upon to operate in environments where exposure to irritants cannot always be adequately controlled. Therefore, candidates with a confirmed history of irritant contact dermatitis should normally be graded P8. Consultation with the single Service consultant occupational physician responsible for recruit selection is recommended to determine the appropriate P grade which will depend upon the intended employment (if known). Psoriasis 3.10.6. Candidates with active psoriasis should normally be graded P8. However, if the extent of the disease is and has always been, mild and it does not interfere with the wearing of military clothing or equipment, candidates may be graded P2. In cases where the extent of the disease has been greater, candidates may be graded P2 provided they have remained free from symptoms whilst off all treatment for 5 years. They should only have ever required treatment with emollients, vitamin D and analogues, or weak steroids. 3.10.7. Guttate psoriasis. Candidates with a history of guttate psoriasis which has fully resolved may be graded P2. Other Skin Diseases 3.10.8. Cysts, scars and keloids. If the size or location of cysts, scars or keloids (from whatever cause) interferes with the wearing of military clothing or equipment candidates are normally be graded P8. 3.10.9. Bullous Dermatoses. Candidates with diseases such as dermatitis herpatiformis, pemphigus and epidermolysis bullosa are normally graded P8. 3.10.10. Fungal Infections. Candidates with extensive recurrent or recalcitrant fungal disease not amenable to treatment are normally graded P8. 3.10.11. Lichen Planus. Candidates with generalised disease that is not responsive to treatment are normally graded P8. 3.10.12. Hyperhidrosis. Candidates with severe disease affecting function are normally graded P8. 3.10.13. Malignant melanoma. All candidates with a past history of malignant melanoma will require formal referral for a dermatology opinion of the prognosis. A decision on medical fitness for entry will then be made by the single Service occupational physician responsible for the selection of recruits. 3.10.14. Photosensitivity. Candidates with any condition sensitive to or aggravated by exposure to sunlight not adequately controlled by sunscreens, are normally graded P8. 3.10.15. Scleroderma. Refer to chapter 3 leaflet 12, Musculoskeletal and connective tissue disorders. 3.10.16. Urticaria and Angio-oedema. Candidates who have a history of urticaria with a systemic reaction or have required treatment in excess of simple antihistamines should normally be graded P8. Otherwise, candidates may be graded P2 but if doubt exists, or there have been repeated and/or chronic episodes of acute urticaria, candidates should be assessed by single Service occupational physician responsible for the selection of recruits.