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Skin cancer - suspected - Management
Melanoma
- Change is a key element in diagnosing malignant melanoma. For low-suspicion lesions, careful monitoring for change should be undertaken using the 7-point checklist for 8 weeks. Measurement should be made with photographs and a marker scale and/or ruler (D).
- All primary healthcare professionals should use the weighted 7-point checklist in the assessment of pigmented lesions to determine referral:
- Major features of the lesions:
- Change in size
- Irregular shape
- Irregular colour
- Minor features of the lesions:
- Largest diameter 7 mm or more
- Inflammation
- Oozing
- Change in sensation
- Suspicion is greater for lesions scoring 3 points or more (based on major features scoring 2 points each and minor features scoring 1 point each). However, if there are strong concerns about cancer, any one feature is adequate to prompt urgent referral (C).
- In patients with a lesion suspected to be melanoma, an urgent referral to a dermatologist or other suitable specialist with experience of melanoma diagnosis should be made, and excision in primary care should be avoided (C).
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