Skin Malignancy

If Dermatology input is required regarding a lesion, please arrange clinical photographs and an internal referral letter for outpatient review should be completed via RMS.

See British Association of Dermatologists website for additional advice.

There are three main subtypes of skin cancer to consider when making a referral:

Basal Cell Carcinoma

See figure 1 for images of basal cell carcinoma. 

Clinical features

• Nodules with rolled, 'pearly' edges
• Telangiectasia is often seen
• Usually present on sun exposed sites, often the face

Basal cell carcinomas progress slowly, rarely metastasise and therefore do not require an urgent referral.

Squamous Cell Carcinoma

See figure 2 for images of squamous cell carcinoma.

Lesions are usually hyperkeratotic, crusty and inflamed with thick scales, often on sun exposed sites such as the face.

Melanoma

See figure 3 for images of melanoma.

Lesions are pigmented and irregular which may change in size, colour, shape and structure (over months to years). Often on sun exposed sites or pre-existing moles.

Look out for ABCDE:

Asymmetry

Border (irregular / bleeding)

Colour (variation)

Diameter (>6mm)

Elevation