Skin Malignancy

If the patient is fit for discharge, please send referral to local out-patient clinic for triage. If admission is likely to be prolonged, discuss with the on-call Dermatology team after arranging clinical photographs.

There are three main subtypes of skin cancer to consider when making a referral:

Basal Cell Carcinoma

See figure 1 for image of basal cell carcinoma. 

Clinical features

  • Nodules with rolled, 'pearly' edges
  • Telangiectasia is often seen
  • Usually present on sun exposed sites, often the face

Basal cell carcinomas progress slowly, rarely metastasise and therefore do not require an urgent referral.

Squamous Cell Carcinoma

See figure 2 for image of squamous cell carcinoma.

Lesions are usually hyperkeratotic, crusty and inflamed with thick scales, often on sun exposed sites such as the face.


See figure 3 for image of melanoma.

Lesions are pigmented and irregular which may change in size, colour, shape and structure (over months to years). Often on sun exposed sites or pre-existing moles.

Look out for ABCDE:


Border (irregular / bleeding)

Colour (variation)

Diameter (>6mm)




Guideline updated: September 2022

Page updated: September 2022