This referral can be used for both Reconstructive and Cosmetic Plastic Surgery Referrals
If the referral is for treatment outside the agreed criteria, please ensure that the Exceptional Factors questions are completed.
FAILURE TO COMPLETE THESE QUESTIONS WILL RESULT IN THE REFERRAL BEING RETURNED TO YOU.
The CCI Referral Guidelines can be found at Plastic Surgery Referral Pathways
Approximately 12,000 people are diagnosed every year with skin cancer in Scotland, of which around 1,200 are malignant melanoma and 3,000 are squamous cell carcinomas (SCC). The incidence of skin cancer is rising.
Risk factors for all skin cancer types include excessive sunlight exposure, sun bed use, fair skin and susceptibility to sunburn. For melanoma, a large number of benign melanocytic naevi and family history are risk factors. For SCC, multiple small actinic keratoses, high levels of previous UV-A photochemotherapy and immuno-suppression are also risk factors. Patients with multiple atypical naevi and a strong family history may have an increased risk of developing skin cancer. Skin cancers are very infrequent in people with dark skin and in children under 15 years.
Guides for assessment include the 7-point checklist and the ABCD (Asymmetry, Border irregular, Colour irregular, Diameter increasing) checklist SIGN Guideline 72 (Withdrawn Feb 2015/Under Review) – Cutaneous Melanoma. Some melanomas will have no major features.
The dermoscope is a useful tool for trained clinicians screening pigmented lesions as it can increase diagnostic accuracy.
A patient presenting with a skin lesion suggestive of cancer should normally be referred to a dermatologist, depending on local arrangements.
Lesions on any part of the body which have one or more of the following features:
The department operates a photo triage system for Skin Cancer referrals. Please phone one of the numbers below to make an appointment for your patient with the Medical Photography department before making a referral. (Please do not delay the referral if there is a difficulty making the appointment)
Hairmyres Hospital: 01355 585497
Monklands Hospital: 01236 712129 or ask for Radio Page 527
Wishaw General Hospital: 01698 366443
Reference:
Scottish Referral Guidelines for Suspected Cancer. Scottish Government, August 2014
SIGN Guideline 72 (Withdrawn Feb 2015/Under Review) – Cutaneous Melanoma
Clinical Lead (Vacant)
Review Date April 2017
This is a dictation template to provide a reminder of the information required to complete the referral. The fields in red are mandatory and must be completed on the referral protocol.
Main Presenting Complaint: [Text – 98 character maximum]
Reason for Referral: [Text]
World Health Organisation Performance Scale
Using the following as a guide, please select the most appropriate answer to describe the patients general health:
Options:
Priority: Urgent Suspicion of Cancer
Expected Outcome:
Date of Onset: [Date]
Will the patient accept any site for treatment:
Duration of lesion (months): [Text]
Site of lesion: [Text]
Size of lesion (mm): [Text]
Are there any changes to the lesion?
If Yes to the above question, Are there any changes to the lesion?, please answer the following:
Change in leasion size:
Is there irregular pigmentation:
Are there irregular borders:
Is the lesion inflamed:
Does the lesion itch or have altered sensation:
Is the lesion larger than others:
Does the lesion bleed or ooze:
Has the patient had previous sunbed exposure:
Is the patient immunosuppressed:
Does the patient have a history of skin cancer:
Has the patient had a previous transplant:
Provisional diagnosis:
Other (please specify): [Text]
This protocol should only be used to refer patients with no suspicion of cancer.
If there is a suspicion of cancer, the patient should be referred using the guidelines and protocols on the Lanarkshire Cancer Referral Centre
This is a dictation template to provide a reminder of the information required to complete the referral. The fields in red are mandatory and must be completed on the referral protocol.
Main Presenting Complaint: [Text – 98 character maximum]
Reason for Referral: [Text]
Date of Onset: [Date]
Priority:
Priority Reason: [Text – 98 character maximum]
Acne Severity:
Before referring a patient for acne, they must have met the following criteria:
Please ensure that all antibiotics prescribed for acne are listed in the medication page of the referral protocol.