{"id":27099,"date":"2026-02-27T12:31:35","date_gmt":"2026-02-27T12:31:35","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/?page_id=27099"},"modified":"2026-03-16T11:38:03","modified_gmt":"2026-03-16T11:38:03","slug":"melanoma","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/melanoma\/","title":{"rendered":"Melanoma"},"content":{"rendered":"\n<p>Melanoma accounts for about 1% of diagnosed skin cancers. Melanoma skin cancer typically starts in skin cells called melanocytes.<\/p>\n\n\n\n<p><strong>Diagnostic Tips<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Malignant melanoma (MM) may be a new lesion or develop in a pre-existing mole. It is <strong>twice as likely<\/strong> for a MM to develop as a new lesion than develop in an existing mole.<\/li>\n\n\n\n<li>Amelanotic malignant melanoma may present as an enlarging, granulating or smooth pink nodule.&nbsp;Beware the solitary pink papule!<\/li>\n\n\n\n<li>Skin cancers are very infrequent in those under 15 years of age<\/li>\n<\/ul>\n\n\n\n<p><strong>Assess risk factors:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>high sun exposure<\/li>\n\n\n\n<li>sun bed use<\/li>\n\n\n\n<li>family history of melanoma<\/li>\n\n\n\n<li>fair skin and a susceptibility to sunburn<\/li>\n\n\n\n<li>large number of melanocytic naevi (greater than 100 naevi has been shown to increase the relative risk of developing melanoma approximately sevenfold compared with 15 or less naevi)<\/li>\n<\/ul>\n\n\n\n<p><strong>Suspect<\/strong> <strong>Melanoma<\/strong> if there is:<\/p>\n\n\n\n<p>The \u201cugly duckling\u201d mole that doesn\u2019t look like its neighbours!<\/p>\n\n\n\n<p>A new mole developing in a person aged 40 or over<\/p>\n\n\n\n<p>A mole with any of the following features (ABCDE criteria):<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>A<\/strong>symmetry<\/li>\n\n\n\n<li><strong>B<\/strong>order (irregular, scalloped)<\/li>\n\n\n\n<li><strong>C<\/strong>olour (irregularity or darkening)<strong>D<\/strong>iameter (larger lesions)<\/li>\n\n\n\n<li><strong>E<\/strong>volution in shape, size or colour over a quick timeframe (few weeks)<\/li>\n<\/ul>\n\n\n\n<p><strong>Suspect<\/strong> <strong>Subungual Melanoma<\/strong> if there is:<\/p>\n\n\n\n<p>Nail pigmentation which evolves but remains in contact with and\/or involves the nail fold (fold of skin that borders the bottom and sides of nail)<\/p>\n\n\n<style>.wp-block-kadence-advancedgallery .kb-gallery-type-masonry.kb-gallery-id-27099_f152ff-a8{margin:-5px;}.kb-gallery-type-masonry.kb-gallery-id-27099_f152ff-a8 .kadence-blocks-gallery-item{padding:5px;}.kb-gallery-id-27099_f152ff-a8 .kadence-blocks-gallery-item .kb-gal-image-radius, .kb-gallery-id-27099_f152ff-a8 .kb-slide-item .kb-gal-image-radius img{border-radius:0px 0px 0px 0px;;}.kb-gallery-caption-style-bottom.kb-gallery-id-27099_f152ff-a8 .kadence-blocks-gallery-item .kadence-blocks-gallery-item-inner .kadence-blocks-gallery-item__caption, .kb-gallery-caption-style-bottom-hover.kb-gallery-id-27099_f152ff-a8 .kadence-blocks-gallery-item .kadence-blocks-gallery-item-inner .kadence-blocks-gallery-item__caption{background:linear-gradient(0deg, rgba(0, 0, 0, 0.8) 0, rgba(0, 0, 0, 0) 100%);}<\/style><div class=\"kb-gallery-wrap-id-27099_f152ff-a8 alignnone wp-block-kadence-advancedgallery\"><ul class=\"kb-gallery-ul kb-gallery-non-static kb-gallery-type-masonry kb-masonry-init kb-gallery-id-27099_f152ff-a8 kb-gallery-caption-style-bottom kb-gallery-filter-none\" data-image-filter=\"none\" data-item-selector=\".kadence-blocks-gallery-item\" data-lightbox-caption=\"true\" data-columns-xxl=\"1\" data-columns-xl=\"1\" data-columns-md=\"1\" data-columns-sm=\"1\" data-columns-xs=\"1\" data-columns-ss=\"1\"><li class=\"kadence-blocks-gallery-item\"><div class=\"kadence-blocks-gallery-item-inner\"><figure class=\"kb-gallery-figure kb-gallery-item-has-link kadence-blocks-gallery-item-has-caption\"><a href=\"https:\/\/dermnetnz.org\/\" class=\"kb-gallery-item-link\" target=\"_blank\" rel=\"noopener noreferrer\"><div class=\"kb-gal-image-radius\" style=\"max-width:640px;\"><div class=\"kb-gallery-image-contain kadence-blocks-gallery-intrinsic\" style=\"padding-bottom:75%;\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Superficial-spreading-melanoma-1.png\" width=\"640\" height=\"480\" alt=\"Superficial spreading melanoma\" data-full-image=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Superficial-spreading-melanoma-1.png\" data-light-image=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Superficial-spreading-melanoma-1.png\" data-id=\"27107\" class=\"wp-image-27107\" srcset=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Superficial-spreading-melanoma-1.png 640w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Superficial-spreading-melanoma-1-300x225.png 300w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/div><div class=\"kadence-blocks-gallery-item__caption\">Superficial spreading melanoma &#8211; DermNetNZ<\/div><\/div><\/a><\/figure><\/div><\/li><li class=\"kadence-blocks-gallery-item\"><div class=\"kadence-blocks-gallery-item-inner\"><figure class=\"kb-gallery-figure kb-gallery-item-has-link kadence-blocks-gallery-item-has-caption\"><a href=\"https:\/\/dermnetnz.org\/\" class=\"kb-gallery-item-link\" target=\"_blank\" rel=\"noopener noreferrer\"><div class=\"kb-gal-image-radius\" style=\"max-width:673px;\"><div class=\"kb-gallery-image-contain kadence-blocks-gallery-intrinsic\" style=\"padding-bottom:74%;\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Nodular-melanoma-1.png\" width=\"673\" height=\"504\" alt=\"Nodular melanoma\" data-full-image=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Nodular-melanoma-1.png\" data-light-image=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Nodular-melanoma-1.png\" data-id=\"27106\" class=\"wp-image-27106\" srcset=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Nodular-melanoma-1.png 673w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Nodular-melanoma-1-300x225.png 300w\" sizes=\"auto, (max-width: 673px) 100vw, 673px\" \/><\/div><div class=\"kadence-blocks-gallery-item__caption\">Nodular melanoma &#8211; DermNetNZ<\/div><\/div><\/a><\/figure><\/div><\/li><li class=\"kadence-blocks-gallery-item\"><div class=\"kadence-blocks-gallery-item-inner\"><figure class=\"kb-gallery-figure kb-gallery-item-has-link kadence-blocks-gallery-item-has-caption\"><a href=\"https:\/\/dermnetnz.org\/\" class=\"kb-gallery-item-link\" target=\"_blank\" rel=\"noopener noreferrer\"><div class=\"kb-gal-image-radius\" style=\"max-width:640px;\"><div class=\"kb-gallery-image-contain kadence-blocks-gallery-intrinsic\" style=\"padding-bottom:75%;\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Amelanotic-melanoma.png\" width=\"640\" height=\"480\" alt=\"Amelanotic melanoma\" data-full-image=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Amelanotic-melanoma.png\" data-light-image=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Amelanotic-melanoma.png\" data-id=\"27105\" class=\"wp-image-27105\" srcset=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Amelanotic-melanoma.png 640w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Amelanotic-melanoma-300x225.png 300w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/div><div class=\"kadence-blocks-gallery-item__caption\">Amelanotic melanoma arising within pigmented melanoma &#8211; DermNetNZ<\/div><\/div><\/a><\/figure><\/div><\/li><\/ul><\/div>\n\n\n<p><\/p>\n\n\n\n<p><strong>Acral-lentiginous melanoma<\/strong> Skin cancer can affect people of all skin colours, including those with brown and black skin. Skin cancer on darker skin often occurs on areas that get little sun exposure, like the palms of hands, soles of feet, and under\/around the nails. People of colour have a higher risk of a late diagnosis and poorer prognosis as skin cancer may be less noticeable or less expected in their skin.<\/p>\n\n\n<style>.kb-image27099_2a9ec3-8e .kb-image-has-overlay:after{opacity:0.3;}<\/style>\n<div class=\"wp-block-kadence-image kb-image27099_2a9ec3-8e\"><figure class=\"aligncenter size-full\"><a href=\"https:\/\/dermnetnz.org\/\" class=\"kb-advanced-image-link\" target=\"_blank\" rel=\"noopener noreferrer\"><img loading=\"lazy\" decoding=\"async\" width=\"640\" height=\"480\" src=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Acral-lentiginous-melanoma.png\" alt=\"Acral lentiginous melanoma\" class=\"kb-img wp-image-27104\" srcset=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Acral-lentiginous-melanoma.png 640w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Acral-lentiginous-melanoma-300x225.png 300w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/a><figcaption>Acral lentiginous malignant melanoma in heel &#8211; DermNetNZ<\/figcaption><\/figure><\/div>\n\n\n\n<p>All images on this page are sourced from&nbsp;<a href=\"https:\/\/dermnetnz.org\/\" target=\"_blank\" rel=\"noreferrer noopener\">DermNet | Dermatology Resource (dermnetnz.org)<\/a><\/p>\n\n\n\n<p><strong>Other skin lesions that are concerning for malignancy<\/strong><\/p>\n\n\n\n<p>The following skin changes should raise concern for a malignant lesion (including Merkel&#8217;s tumour, sarcoma, or amelanotic melanoma):<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Nodule grows quickly (over weeks)<\/li>\n\n\n\n<li>A new change (growth, pigmentation, or pain) in a long-standing ulcer, scar, traumatic or inflamed area of skin<\/li>\n\n\n\n<li>Non-healing and\/or destructive atypical ulcer<\/li>\n\n\n\n<li>Progressive unexplained scar-like area<\/li>\n\n\n\n<li>An unexplained skin lesion with loco-regional lymphadenopathy<\/li>\n<\/ul>\n\n\n\n<p>Please refer these via the Melanoma pathway below.<\/p>\n\n\n\n<p><strong><strong>B.C, C.L &amp; P.O<\/strong> &#8211; 16-03-2026<\/strong><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p>Refer as USOC via Sci Gateway: Lauriston\/SJH&gt;Dermatology&gt;LI Suspected Melanoma.<\/p>\n\n\n\n<p>Please use the&nbsp;<a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/using-the-consultant-connect-app\/\" target=\"_blank\" rel=\"noreferrer noopener\">Using the Consultant Connect App \u2013 RefHelp<\/a><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/CCA4Poster.pdf\" target=\"_blank\" rel=\"noreferrer noopener\"><strong> <\/strong><\/a>&nbsp;to take photos of the lesion(s) and then attach these to your Sci Gateway referral.<\/p>\n\n\n\n<p><a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/dermatology\/attaching-photos-to-referrals\/\" target=\"_blank\" rel=\"noreferrer noopener\">Attaching photos to referrals \u2013 RefHelp<\/a><\/p>\n\n\n\n<p>Any patient who has a malignant melanoma removed in primary care must be referred USOC via the above pathway.<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><strong>For Patients<\/strong><\/p>\n\n\n\n<p>The BAD (British Association&nbsp;of Dermatologists) have several PILs on melanoma depending on the stage of the disease. These can be found at: <a href=\"https:\/\/www.skinhealthinfo.org.uk\/a-z-conditions-treatments\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.skinhealthinfo.org.uk\/a-z-conditions-treatments\/<\/a>&nbsp;&amp; search for \u201cmelanoma\u201d.<\/p>\n\n\n\n<p><strong>For Healthcare Professionals<\/strong><\/p>\n\n\n\n<p>Primary Care Dermatology Society \u2013&nbsp;<a href=\"http:\/\/www.pcds.org.uk\/clinical-guidance\/melanoma-an-overview1\" target=\"_blank\" rel=\"noreferrer noopener\">http:\/\/www.pcds.org.uk\/clinical-guidance\/melanoma-an-overview1<\/a><\/p>\n\n\n\n<p>Scottish Referral Guidelines for suspected Cancer &#8211; &nbsp;<a href=\"https:\/\/www.gov.scot\/binaries\/content\/documents\/govscot\/publications\/advice-and-guidance\/2025\/08\/scottish-referral-guidelines-suspected-cancer-2025\/documents\/scottish-referral-guidelines-suspected-cancer-2025\/scottish-referral-guidelines-suspected-cancer-2025\/govscot%3Adocument\/scottish-referral-guidelines-suspected-cancer-2025.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Scottish Referral Guidelines for Suspected Cancer 2025<\/a><\/p>\n\n\n\n<p>Dermnet nz \u2013&nbsp;<a href=\"https:\/\/www.dermnetnz.org\/topics\/melanoma\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.dermnetnz.org\/topics\/melanoma\/<\/a><\/p>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Melanoma accounts for about 1% of diagnosed skin cancers. Melanoma skin cancer typically starts in skin cells called melanocytes. Diagnostic Tips Assess risk factors: Suspect Melanoma if there is: The &ldquo;ugly duckling&rdquo; mole that doesn&rsquo;t look like its neighbours! A new mole developing in a person aged 40 or over A mole with any of<\/p>\n","protected":false},"author":20,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[],"class_list":["post-27099","page","type-page","status-publish","hentry"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"mariamazoysaavedra","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/mariamazoysaavedra\/"},"rttpg_comment":0,"rttpg_category":false,"rttpg_excerpt":"Melanoma accounts for about 1% of diagnosed skin cancers. Melanoma skin cancer typically starts in skin cells called melanocytes. Diagnostic Tips Assess risk factors: Suspect Melanoma if there is: The &ldquo;ugly duckling&rdquo; mole that doesn&rsquo;t look like its neighbours! A new mole developing in a person aged 40 or over A mole with any of","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/27099","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/20"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=27099"}],"version-history":[{"count":8,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/27099\/revisions"}],"predecessor-version":[{"id":27277,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/27099\/revisions\/27277"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=27099"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=27099"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}