Scottish referral guidelines for suspected cancer: quick reference guide

Skin Cancers

Melanoma

Pigmented lesions on any part of the body which have one or more of the following features:

• Rapid growth in height or area.
• Change in colour or more than three colours at presentation.
• Lesion which is significantly different from patient's other moles.
• Growing subungual lesions.
• Lesion with persistent surrounding inflammation or altered sensation.
• Persistent ulceration, bleeding or oozing in absence of trauma.
• New growing nodule whether pigmented or not.

Squamous Cell Carcinoma

Urgent referral for:

• Lesions which grow rapidly over 6 weeks, especially on ear, columella or lip.
• Slow growing, non-healing lesions with induration (esp. face, scalp, back of hand) expanding over 1-2 months.
• If invasive SCC diagnosed from biopsy undertaken in general practice.
• Patients who are immunosuppressed especially after organ transplantation have a higher incidence of aggressive SCC with metastatic potential compared to immune competent patients.

Basal Cell Carcinoma

• The majority of BCCs do not need urgent referral.
• Lesions with very long history (>10 years) have the potential to metastasise.
• Urgent referral for recurrent BCC and those invading potentially dangerous areas, e.g. auditory meatus, eye, base of nose or any major vessel.