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Skin and soft tissue pathology – benign and malignant


Minimum Referral Criteria

  • Category 1
    (appointment within 30 calendar days)
    • Skin lesion highly suspicious for melanoma or excision biopsy proven melanoma – including re-excision
    • High degree of clinical suspicion
    • Large SCC, BCC
    • Rapidly growing skin lesions especially on the face
    • Non-melanoma skin malignancies and any of the following:
      • ulceration and bleeding
      • rapidly enlarging
      • neurological involvement
      • lymphadenopathy
    • Poorly differentiated or infiltrative tumour on biopsy
    • Soft tissue tumour with atypical features
    • Ingrown toenail with infection having failed primary care management

  • Category 2
    (appointment within 90 calendar days)
    • Small truncal or peripheral limb BCC or SCC or IEC
  • Category 3
    (appointment within 365 calendar days)
    • Benign soft tissue lesions e.g. lipoma ganglion not suitable for primary health management

1. Reason for request Indicate on the referral

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

2. Essential referral information Referral will be returned without this

  • Pigmented lesion features: size, shape, colour, inflammation, oozing, change in sensation

3. Additional referral information Useful for processing the referral

  • Biopsy results unless clinically contraindicated. Excision biopsy is the preferred method for biopsy suspected melanoma
  • Smoking status
  • Anticoagulant therapy
  • USS of lesion (for a suspicious lipoma)
  • CT results – if malignancy suspected
  • Photograph – with patient's consent, where secure image transfer, identification and storage is possible

4. Request

Last updated: 13 June 2023