{"id":3731,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/benign-lesion-skin-tags-warts-moles-dermatofibroma\/"},"modified":"2025-07-28T13:20:33","modified_gmt":"2025-07-28T12:20:33","slug":"benign-lesion-skin-tags-warts-moles-dermatofibroma","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/dermatology\/benign-lesion-skin-tags-warts-moles-dermatofibroma\/","title":{"rendered":"Benign Lesion (Skin Tags, Warts, Moles, Dermatofibroma)"},"content":{"rendered":"\n<div class=\"wp-block-media-text alignwide is-stacked-on-mobile\" style=\"grid-template-columns:31% auto\"><figure class=\"wp-block-media-text__media\"><img loading=\"lazy\" decoding=\"async\" width=\"640\" height=\"480\" src=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Skin-Tag.png\" alt=\"Skin Tag\" class=\"wp-image-19228 size-full\" srcset=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Skin-Tag.png 640w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Skin-Tag-300x225.png 300w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/figure><div class=\"wp-block-media-text__content\">\n<p><strong>Skin Tags<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Soft flesh coloured or pigmented pedunculated tags in body folds&nbsp;(neck,&nbsp;armpit, groin)<\/li>\n\n\n\n<li>Especially in obese patients and in those with type 2 diabetes<\/li>\n<\/ul>\n\n\n\n<p><a href=\"https:\/\/dermnetnz.org\/#gsc.tab=1&amp;gsc.q=skin%20tags\">Search DermNet | DermNet (dermnetnz.org)<\/a><\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-media-text alignwide is-stacked-on-mobile\" style=\"grid-template-columns:31% auto\"><figure class=\"wp-block-media-text__media\"><img loading=\"lazy\" decoding=\"async\" width=\"640\" height=\"480\" src=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Seborrhoeic-Keratosis.png\" alt=\"Seborrhoeic Keratosis\" class=\"wp-image-19227 size-full\" srcset=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Seborrhoeic-Keratosis.png 640w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Seborrhoeic-Keratosis-300x225.png 300w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/figure><div class=\"wp-block-media-text__content\">\n<p><strong>Seborrhoeic Keratoses&nbsp; (warts)<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>&#8211; Yellow \/ brown greasy papules or rough grey \/ black hyperkeratotic papules with \u2018stuck-on\u2019 appearance<\/li>\n\n\n\n<li>&#8211; Keratin plugs or inclusion cysts may help differentiate from melanoma<\/li>\n\n\n\n<li>&#8211; Often multiple<\/li>\n<\/ul>\n\n\n\n<p><a href=\"https:\/\/dermnetnz.org\/#gsc.tab=1&amp;gsc.q=Seborrhoeic%20keratoses&amp;gsc.page=1\">Search DermNet | DermNet (dermnetnz.org)<\/a><\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-media-text alignwide is-stacked-on-mobile\" style=\"grid-template-columns:31% auto\"><figure class=\"wp-block-media-text__media\"><img loading=\"lazy\" decoding=\"async\" width=\"639\" height=\"480\" src=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Dermatofibroma.png\" alt=\"Dermatofibroma\" class=\"wp-image-19226 size-full\" srcset=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Dermatofibroma.png 639w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Dermatofibroma-300x225.png 300w\" sizes=\"auto, (max-width: 639px) 100vw, 639px\" \/><\/figure><div class=\"wp-block-media-text__content\">\n<p><strong>Dermatofibroma<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Firm reddish brown nodules often on the limbs. May be tender on pressure<\/li>\n\n\n\n<li>If the skin over a dermatofibroma is squeezed a dimple forms, indicating tethering of the skin to the underlying fibrous&nbsp;tissue<\/li>\n<\/ul>\n\n\n\n<p><a href=\"https:\/\/dermnetnz.org\/topics\/dermatofibroma\">DermNet (dermnetnz.org)<\/a><\/p>\n<\/div><\/div>\n\n\n\n<p><strong>Benign Melanocytic Naevi (moles)<br><\/strong><br>&#8211; Flat or raised, symmetrical, uniform border, uniform pigment, pale, dark or reddish brown<br>&#8211; May darken\/enlarge during pregnancy. If hairy may become inflamed (folliculitis)<\/p>\n\n\n\n<p><strong>R.C 18-05-24<\/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<h4 class=\"wp-block-heading\">Dermatology Referral Criteria<\/h4>\n\n\n\n<p>Referral of patients with benign tumours may be appropriate if there is:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Diagnostic doubt or concerns over possible malignancy.&nbsp;<\/li>\n\n\n\n<li>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).<\/li>\n\n\n\n<li>Benign lesions which are disfiguring or are cosmetically sensitive should be referred to plastics through the EARP (see\u00a0<a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/Pages\/AestheticSurgery.aspx\" target=\"_blank\" rel=\"noreferrer noopener\">AestheticSurgery.aspx<\/a>).<\/li>\n\n\n\n<li>Please use the <a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/CCA4Poster.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Consultant Connect app<\/a> to take photos of the lesion(s) and then attach these to your Sci Gateway referral.<\/li>\n\n\n\n<li><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><\/li>\n<\/ul>\n\n\n\n<p><em>Kindly inform patients prior to referral that if a skin lesion is diagnosed as benign, it is highly unlikely to be removed in secondary care for cosmetic reasons alone.<\/em><\/p>\n\n\n\n<p>Please do not refer lesions that are known to be benign to the dermatology department for cryotherapy.<\/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<h4 class=\"wp-block-heading\">Skin tags<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>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.&nbsp;<\/li>\n\n\n\n<li>If above not possible, consider treatment in Primary Care by cryotherapy or snip\/shave + cautery, if available.<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Seborrhoeic&nbsp; Keratoses<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Seborrhoeic&nbsp; Keratoses<\/li>\n\n\n\n<li>If diagnosis certain, reassure that no treatment is needed<\/li>\n<\/ul>\n\n\n\n<p>Treatment in Primary Care, if available, can be considered for symptomatic lesions:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Cryotherapy<\/li>\n\n\n\n<li>Curettage for large lesions (specimen to be sent to pathology)<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Benign Melanocytic Naevi (moles)<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Do not refer patients with moles for cosmetic removal<\/li>\n\n\n\n<li>Excision of benign naevi only if they meet the criteria as outlined in the exceptional referral pathway <\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Dermatofibroma<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>If diagnosis is certain, reassure that no treatment is needed<\/li>\n\n\n\n<li>Excision, if indicated e.g. significant pain or discomfort, is the treatment of choice<\/li>\n\n\n\n<li>Warn patient about resulting scar<\/li>\n\n\n\n<li>Send specimen to pathology<\/li>\n<\/ul>\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<h4 class=\"wp-block-heading\">For Patients<\/h4>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Relevant patient information leaflets can be found at:<\/strong>&nbsp;<\/h4>\n\n\n\n<h4 class=\"wp-block-heading\"><a href=\"http:\/\/www.bad.org.uk\/for-the-public\/patient-information-leaflets\" target=\"_blank\" rel=\"noreferrer noopener\">www.bad.org.uk\/for-the-public\/patient-information-leaflets<\/a><\/h4>\n\n\n\n<h4 class=\"wp-block-heading\">For Professionals&nbsp;<\/h4>\n\n\n\n<p><a href=\"http:\/\/www.pcds.org.uk\/clinical-guidance\/seborrhoeic-keratosis-syn.-seborrhoeic-wart-basal-cell-papilloma\" target=\"_blank\" rel=\"noreferrer noopener\">Link to PCDS Seborrhoeic keratosis seborrhoeic wart Basal cell papilloma clinical guidance<\/a><\/p>\n\n\n\n<p><a href=\"http:\/\/www.pcds.org.uk\/clinical-guidance\/melanocytic-naevi\" target=\"_blank\" rel=\"noreferrer noopener\">Link to Melanocytic Naevi clinical guidance<\/a><\/p>\n\n\n\n<p><a href=\"http:\/\/www.pcds.org.uk\/clinical-guidance\/dermatofibroma-syn.-histiocytoma\" target=\"_blank\" rel=\"noreferrer noopener\">Link to PCDS Dermatofibroma\/Histiocytoma clinical guidance<\/a><\/p>\n\n\n\n<p><a href=\"https:\/\/www.sehd.scot.nhs.uk\/cmo\/CMO(2019)05.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.sehd.scot.nhs.uk\/cmo\/CMO(2019)05.pdf<\/a><\/p>\n\n\n\n<p><\/p>\n\n\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Benign Melanocytic Naevi (moles)&ndash; Flat or raised, symmetrical, uniform border, uniform pigment, pale, dark or reddish brown&ndash; May darken\/enlarge during pregnancy. If hairy may become inflamed (folliculitis) R.C 18-05-24<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":3853,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[99],"class_list":["post-3731","page","type-page","status-publish","hentry","category-benignlesionskintagswartsmolesdermatofibroma"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/dermatology\/benignlesionskintagswartsmolesdermatofibroma\/\" rel=\"tag\">Benign Lesion (Skin Tags, Warts, Moles, Dermatofibroma)<\/a>","rttpg_excerpt":"Benign Melanocytic Naevi (moles)&ndash; Flat or raised, symmetrical, uniform border, uniform pigment, pale, dark or reddish brown&ndash; May darken\/enlarge during pregnancy. If hairy may become inflamed (folliculitis) R.C 18-05-24","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3731","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\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=3731"}],"version-history":[{"count":21,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3731\/revisions"}],"predecessor-version":[{"id":24924,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3731\/revisions\/24924"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3853"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=3731"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=3731"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}