April 2026
95% of people with Hodgkin’s Lymphoma present with lymph node involvement. Detailed list of clinical features and investigations to be done is outlined on our new Lymphoma page. Please see here: https://apps.nhslothian.scot/refhelp/lymphoma/
RefHelp’s Cytosponge page renamed to Capsule Sponge. Please see the recently updated page here: https://apps.nhslothian.scot/refhelp/guidelines/gastrointestinal/capsulesponge/
As per Scottish Cancer Referral Guidance, if weight loss is unintentional & >5% of body weight, then it is acceptable to include a strong clinical suspicion of weight loss in your referral. Detailed referral advice here: https://apps.nhslothian.scot/refhelp/guidelines/medicineoftheelderlygeriatrics/weightloss/
New page on Breast Cancer added to RefHelp outlining key information for primary care practitioners on diagnosis, referral, contacts, post-surgery complications, post radiotherapy skin changes, bone health, managing menopausal symptoms, and much more: https://apps.nhslothian.scot/refhelp/breast-cancer/
Please see advice on management of post radiotherapy skin reactions in breast cancer patients. Also, included is a useful guide for post-surgery arm exercises: https://apps.nhslothian.scot/refhelp/post-radiotherapy-skin-care-for-breast-cancer-patients/
Please note all lesion referrals to Dermatology should be accompanied by a good quality photograph. Info on attaching photos to referrals here: https://apps.nhslothian.scot/refhelp/guidelines/dermatology/attaching-photos-to-referrals/
When there are technical barriers to sending a photograph, please use Medical Photography Exceptions Pathway to refer the patient to Lauriston Building for a photo. Once the patient has attended, you will be notified so you can then refer to Dermatology. https://apps.nhslothian.scot/refhelp/photo-exception-pathway/
Malignant Melanoma (MM) is twice as likely to develop as a new lesion than develop in an existing mole. Info on diagnostic tips, assessing risk factors, images to help diagnosis, and referral details included on the new MM page here: https://apps.nhslothian.scot/refhelp/melanoma/
New page on Basal Cell Carcinoma including clinical features, images to help diagnosis, criteria for removal in primary care, and clearly outlined referral guidelines: https://apps.nhslothian.scot/refhelp/basal-cell-carcinoma/
Guidance document on lab sample requesting in the event of electronic order system downtime added to RefHelp: https://apps.nhslothian.scot/refhelp/guidelines/laboratoryservices/ A contingency arrangement when the ICE/GP Order comms will be unavailable during the ICE system upgrade scheduled for 22 April 8am -5pm.
Around 23% of skin cancers are Squamous Cell Carcinomas and upto 5% metastasise. New page added on SCC covering risk factors, differential diagnosis, referral guidelines, and useful resources & links such as PILs. Please visit the new page here: https://apps.nhslothian.scot/refhelp/squamous-cell-carcinoma/
New section added to RefHelp Paediatrics on Surgical Emergencies covering Appendicitis, Incarcerated Hernia, Intussusception, Malrotation, & Testicular Torsion. More details about clinical features, differential diagnosis, & referral guidelines here: https://apps.nhslothian.scot/refhelp/surgical-emergencies/
Some patients may still be suitable for an Urgent Suspicion of Cancer referral despite a normal CXR. For specific referral criteria please see recently updated lung cancer page: https://apps.nhslothian.scot/refhelp/guidelines/respiratory/lungcancer/
