Skin Cancer - Melanoma

Urgent Referral

Refer urgently patients

• with a lesion suspected to be melanoma (excision in primary care should be avoided) - see melanoma checklists below

Skin Cancer - Squamous Cell Carcinoma

Urgent Referral

Refer urgently patients

• with non-healing crusted tumours >1cm with significant induration on palpation (commonly found on the face, scalp or back of the hand with a documented expansion over 8 weeks)
• who have had an organ transplant and develop new or growing cutaneous lesions as squamous cell carcinoma is common with immunosuppression but may be atypical and aggressive
• with histological diagnosis of a squamous cell carcinoma

Skin Cancer - Basal Cell Carcinoma

Non-urgent referral

Basal cell carcinomas are slow growing, usually without significant expansion over 2 months, and usually occur on the face. If basal cell carcinoma is suspected, refer non-urgently

Skin Cancer - Pigmented Lesions - Checklists

Melanoma should be considered if any of the characteristics in either the Glasgow 7-point checklist or the ABCDE checklist is found.

Glasgow 7-point Checklist for Melanoma

Refer people using a suspected cancer pathway referral (2 week wait) for melanoma if they have a suspicious pigmented skin lesion with a (weighted) Glasgow 7-point checklist score of 3 or more.

• Major (each one scores 2 points)
  • Change in size of lesion
  • Irregular pigmentation
  • Irregular border
• Minor (each one scores one point)
  • Inflammation
  • Itch / Altered sensation
  • Lesion larger than others
  • Oozing / Crusting of lesion

The ABCDE of Melanoma

• A - Asymmetry
• B - Border irregularity
• C - Colour variation
• D - Diameter > 6mm
• E - Evolving (enlarging / changing)