Skin: Guidelines for Urgent Referral

Melanoma

• Pigmented lesions on any part of the body which have one or more of the following features:
• growing in size
• changing shape
• irregular outline
• changing colour
• mixed colour
• ulceration
• inflammation

NB. Melanomas are usually 5mm or greater at the time of diagnosis, but a small number of patients with very early melanoma may have lesions of a smaller diameter than this.

Squamous Cell Carcinoma

• Slowly growing, non-healing lesions with a significant induration on palpation (commonly on face, scalp, back of hand) – with documented expansion over a period of 1 – 2 months.

• Patients in whom squamous cell carcinoma has been diagnosed from a biopsy undertaken in general practice.

• Patients who are therapeutically immuno suppressed after an organ transplant have a high incidence of skin cancers mainly squamous cell carcinoma. These tumours can be unusually aggressive and metastasize. It is therefore strongly recommended that transplant patients who develop new or growing cutaneous lesions should be referred under the two week standard.