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Skin – 2WW

  

Information and referral forms for 2WW Skin


2WW Referral Criteria for Skin Lesions

Melanoma

Clinicians may use EITHER the ABCD rules OR NICE weighted 7-point checklist:

A B C D rules apply to melanocytic lesions only. Change often occurs in 3-12 months

Melanomas are generally not keratotic (crusty), unlike Seborrhoeic Keratoses Please indicate if there has been any change in:

A. Asymmetry (change in symmetry)

B. Border (change to be irregular, blurred edges)   

C. Colour (change in colour or change to have more than one colour, even if lighter)

D. Diameter (change in diameter, especially if change to be greater than 6mm)

OR: NICE weighted 7-point checklist score of  3  or more

MAJOR features of the lesions (scoring 2 points each):

  • Change in size
  • Irregular shape
  • Irregular colour

MINOR features of the lesions (scoring 1 point each):

  • Largest diameter 7 mm or more
  • Inflammation
  • Oozing
  • Change in sensation

Additional important clinical information

  • Previous history of skin cancer
  • Family history of skin cancer
  • Immunosuppression
  • Pacemaker (or another electronic implanted device?)
  • Please include the history and location of the lesion and attach any photographs.

SQUAMOUS CELL CARCINOMA (SCC) 

These are from Keratinocytes and usually have adherent keratin. Poorly differentiated SCCs can just be ulcerated. Refer Keratoacanthomas as if they are SCCs.

NB: Usually appear as a red, prominent nodule or a non-healing ulcer. In some cases, a keratin core is present (possible keratoacanthoma) which should be referred in case they are SCCs.

Features:

  • Dermal induration (nodular)
  • Expansion over weeks to months
  • Tender
  • Keratin producing (adherent)
  • Ulcerated pink lesion

CRITICAL SITE BASAL CELL CARCINOMA (BCC)

Critical sites

  • Eyelid margin
  • Nostril rim
  • Vermilion border of lip
  • External auditory meatus
  • (All others are routine referral)

Document size (If <2 cm and not critical site refer to DMC)

Additional important clinical information:

  • Previous history of skin cancer
  • Family history of skin cancer
  • Immunosuppression
  • Anticoagulants
  • Pacemaker (or another electronic implanted device)

Please include the history and location of the lesion and attach any photographs to the referral.

Consider handing the patient a Cancer Research UK Information Sheet – follow link

Two Week Wait referrals should now be processed through the NHS eReferral Service (previously known as Choose & Book)

Skin 2WW Referral Form 2022

See image below. For printable version follow Referral Link right

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