Skin Tags
- Soft flesh coloured or pigmented pedunculated tags in body folds (neck, armpit, groin)
- Especially in obese patients and in those with type 2 diabetes
Seborrhoeic Keratoses (warts)
- – Yellow / brown greasy papules or rough grey / black hyperkeratotic papules with ‘stuck-on’ appearance
- – Keratin plugs or inclusion cysts may help differentiate from melanoma
- – Often multiple
Dermatofibroma
- Firm reddish brown nodules often on the limbs. May be tender on pressure
- If the skin over a dermatofibroma is squeezed a dimple forms, indicating tethering of the skin to the underlying fibrous tissue
Benign Melanocytic Naevi (moles)
– Flat or raised, symmetrical, uniform border, uniform pigment, pale, dark or reddish brown
– May darken/enlarge during pregnancy. If hairy may become inflamed (folliculitis)
R.C 18-05-24
Dermatology Referral Criteria
Referral of patients with benign tumours may be appropriate if there is:
- Diagnostic doubt or concerns over possible malignancy.
- If there is no diagnostic doubt and the lesion is causing significant functional disability or recurrent trauma/infection then please refer to your locality minor surgery service (see Refhelp page on Minor Surgery).
- Benign lesions which are disfiguring or are cosmetically sensitive should be referred to plastics through the EARP (see AestheticSurgery.aspx).
Kindly inform patients prior to referral that if a skin lesion is diagnosed as benign, it highly unlikely to be removed in secondary care for cosmetic reasons alone.
Please do not refer lesions that are known to be benign to the dermatology department for cryotherapy.
Skin tags
- Small (few mm in size) skin tags rarely cause significant disability. Patients should be advised that they can remove small (few mm in size) skin tags themselves with suitably disinfected nail clippers or scissors.
- If above not possible, consider treatment in Primary Care by cryotherapy or snip/shave + cautery, if available.
Seborrhoeic Keratoses
- Seborrhoeic Keratoses
- If diagnosis certain, reassure that no treatment is needed
Treatment in Primary Care, if available, can be considered for symptomatic lesions:
- Cryotherapy
- Curettage for large lesions (specimen to be sent to pathology)
Benign Melanocytic Naevi (moles)
- Do not refer patients with moles for cosmetic removal
- Excision of benign naevi only if they meet the criteria as outlined in the exceptional referral pathway
Dermatofibroma
- If diagnosis is certain, reassure that no treatment is needed
- Excision, if indicated e.g. significant pain or discomfort, is the treatment of choice
- Warn patient about resulting scar
- Send specimen to pathology
For Patients
Relevant patient information leaflets can be found at:
www.bad.org.uk/for-the-public/patient-information-leaflets
For Professionals
Link to PCDS Seborrhoeic keratosis seborrhoeic wart Basal cell papilloma clinical guidance
Link to Melanocytic Naevi clinical guidance
