If the patient is fit for discharge, please send a referral to the local outpatient clinic for triage. If admission is likely to be prolonged, arrange clinical photographs and send an urgent referral letter to the dermatology secretaries.
There are three main subtypes of skin cancer to consider when making a referral:
See figure 1 for image of basal cell carcinoma.
Basal cell carcinomas progress slowly, rarely metastasise and therefore do not require an urgent referral.
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. These can metastasise and be aggressive and would necessitate an urgent referral.
See figure 3 for image of melanoma.
Lesions are pigmented and irregular, and may change in size, colour, shape and structure (over months to years). Often on sun-exposed sites or pre-existing moles. Melanoma can metastasise and be aggressive and would necessitate an urgent referral.
Asymmetry
Border (irregular / bleeding)
Colour (variation)
Diameter (>6mm)
Elevation
Guideline updated: February 2026
Page updated: June 2026
