{"id":3853,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/dermatology\/"},"modified":"2026-03-12T09:12:07","modified_gmt":"2026-03-12T09:12:07","slug":"dermatology","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/dermatology\/","title":{"rendered":"Dermatology"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><strong>Introduction<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">NHS Lothian Dermatology department will be implementing the updated Scottish Referral Guidelines for Suspected Cancer from 16th March 2026 (<a href=\"https:\/\/www.gov.scot\/publications\/scottish-referral-guidelines-suspected-cancer-2025\/\" target=\"_blank\" rel=\"noreferrer noopener\">Scottish Referral Guidelines for Suspected Cancer 2025 \u2013 gov.scot<\/a>). In addition to <strong>suspected melanomas, suspected SCCs<\/strong>\u00a0and <strong>high risk BCCs <\/strong>should be referred through USOC pathways. RefHelp has been updated to reflect this and you will find new SCI Gateway referral proformas for USOC-Melanoma, USOC- SCC and USOC-High risk BCC.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">These changes will put additional pressure on our USOC pathway. Currently, only a very small percentage of patients referred via this pathway have a high-risk skin cancer (less than 5%). From 16th&nbsp;March 2026,<strong>&nbsp;all lesion referrals should be accompanied by a good quality photograph to support the triage process.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Photographs are an essential part of Active Clinical Referral Triage (ACRT) and enables the priority of patients to be upgraded or downgraded. Photo triage enables more patients to be streamlined directly to treatment or biopsy without the need for a face-to-face review of the lesion in a clinic and allows more patients to be safely discharged from Secondary Care with advice or reassurance. This is important in managing the volume of Urgent Suspicious of Cancer (USOC) referrals.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Please see the following for more information about taking photos and attaching them to referrals :<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><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 class=\"wp-block-paragraph\"><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><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/photo-exception-pathway\/\" target=\"_blank\" rel=\"noreferrer noopener\">Photo Exception Pathway \u2013 RefHelp<\/a> <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For contact details and information about specialist clinics see <a href=\"http:\/\/intranet.lothian.scot.nhs.uk\/Directory\/Dermatology\/Pages\/default.aspx\" target=\"_blank\" rel=\"noreferrer noopener\">Dermatology<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B.C, C.L &amp; P.O &#8211; 12-3-26<\/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\">Who to refer &amp; Who not to refer:<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">The following topics are covered by this referral advice.&nbsp;Clinicians are asked to follow the Primary Care Management guidance on RefHelp whenever possible&nbsp;<strong><em>prior<\/em><\/strong>&nbsp;to making any referral. Referrals may be declined unless there is a clearly documented valid&nbsp;<strong><em>clinical<\/em><\/strong>&nbsp;reason why this is not the case.<\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-large\"><div class=\"wpcp-wp-lightbox-host wpcp-advanced-image-lightbox-icon-hover\"><a class=\"wpcp-wp-lightbox-image-link\" href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Dermatology-flowchart-v10.png\" data-wpcp-wp-lb-image=\"1\"><img loading=\"lazy\" decoding=\"async\" width=\"817\" height=\"1024\" src=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Dermatology-flowchart-v10-817x1024.png\" alt=\"Dermatology flowchart\" class=\"wp-image-16882\" srcset=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Dermatology-flowchart-v10-817x1024.png 817w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Dermatology-flowchart-v10-239x300.png 239w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Dermatology-flowchart-v10-768x963.png 768w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Dermatology-flowchart-v10-1225x1536.png 1225w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Dermatology-flowchart-v10-1634x2048.png 1634w, https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Dermatology-flowchart-v10-909x1140.png 909w\" sizes=\"auto, (max-width: 817px) 100vw, 817px\" \/><\/a><figcaption><span class=\"media-credit\">NHS Lothian<\/span><\/figcaption><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Dermatology-flowchart-v10.png\" data-fancybox=\"wpcp-wp-img-16882\" class=\"wpcp-lightbox-trigger wpcp-advanced-image-lightbox-icon wpcp-position-top-right wpcp-advanced-image-lightbox-icon-hover wpcp-global-lightbox-icon wpcp-lightbox-icon--global wpcp-lb-icon-style-default\" data-wpcp-lb-icon-source=\"global\" aria-label=\"Open image in lightbox\" data-thumb-src=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Dermatology-flowchart-v10-239x300.png\" data-wpcp-lb-single=\"1\"><span class=\"wpcp-icon-container\"><svg viewBox=\"0 0 20 20\"><path d=\"M17.6585 16.025L14.2437 12.6198C15.1716 11.3338 15.6121 9.7613 15.4871 8.1819C15.362 6.60251 14.6795 5.11847 13.5607 3.99351C12.936 3.36206 12.1916 2.86066 11.3709 2.51845C10.5502 2.17623 9.66952 2 8.77995 2C7.89039 2 7.00969 2.17623 6.18899 2.51845C5.36829 2.86066 4.62395 3.36206 3.99919 3.99351C3.36594 4.61649 2.86312 5.35871 2.51992 6.17708C2.17673 6.99545 2 7.87365 2 8.76068C2 9.64772 2.17673 10.5259 2.51992 11.3443C2.86312 12.1627 3.36594 12.9049 3.99919 13.5279C5.11957 14.6901 6.62279 15.4103 8.23285 15.5562C9.84291 15.7022 11.4517 15.2641 12.7639 14.3224L16.1788 17.7275C16.3849 17.9034 16.6473 18 16.9186 18C17.1899 18 17.4523 17.9034 17.6585 17.7275C18.1138 17.16 18.1138 16.5925 17.6585 16.025ZM5.59278 12.0523C5.16258 11.6298 4.82094 11.1263 4.58774 10.5709C4.35455 10.0156 4.23446 9.41951 4.23446 8.81744C4.23446 8.21536 4.35455 7.6193 4.58774 7.06394C4.82094 6.50859 5.16258 6.00503 5.59278 5.58257C6.01644 5.15359 6.52144 4.81292 7.07838 4.58039C7.63532 4.34786 8.23308 4.22811 8.83687 4.22811C9.44066 4.22811 10.0384 4.34786 10.5954 4.58039C11.1523 4.81292 11.6573 5.15359 12.081 5.58257C12.5112 6.00503 12.8528 6.50859 13.086 7.06394C13.3192 7.6193 13.4393 8.21536 13.4393 8.81744C13.4393 9.41951 13.3192 10.0156 13.086 10.5709C12.8528 11.1263 12.5112 11.6298 12.081 12.0523C11.6573 12.4813 11.1523 12.822 10.5954 13.0545C10.0384 13.287 9.44066 13.4068 8.83687 13.4068C8.23308 13.4068 7.63532 13.287 7.07838 13.0545C6.52144 12.822 6.01644 12.4813 5.59278 12.0523Z\" \/><\/svg><\/span><\/a><\/div><\/figure>\n<\/div>\n\n\n<p class=\"wp-block-paragraph\"><strong><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Dermatology-Home-page-flowchart-v10.pdf\" data-type=\"link\" data-id=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Dermatology-Home-page-flowchart-v10.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Click here for&nbsp;PDF version<\/a><\/strong><\/p>\n\n\n\n<h4 class=\"wp-block-heading\">How to refer:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>SCI-Gateway referral protocols for lesions are now&nbsp;asking if a dermatoscopic image has been sent. Just tick no if this is not available.<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Adults (Aged 16 or over at the date of referral)<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">SCI Gateway \u2013LB\/SJH\/ELCH-dermatology<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Children (Aged under 16 at the date of referral)<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">SCI Gateway- RHCYP-dermatology<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Note the exception for Children with acne vulgaris aged 13 or over at the date of referral should be referred to Adult dermatology<\/li>\n\n\n\n<li>The more detail you are able to provide with regard to the history and description of the lesion\/rash in question, the better able we are to triage appropriately.<\/li>\n\n\n\n<li><a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/attaching-photos-to-referrals\/\" target=\"_blank\" rel=\"noreferrer noopener\">Attaching photos to referrals \u2013 RefHelp<\/a><\/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<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.aad.org\/\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.aad.org\/<\/a><\/p>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Introduction NHS Lothian Dermatology department will be implementing the updated Scottish Referral Guidelines for Suspected Cancer from 16th March 2026 (Scottish Referral Guidelines for Suspected Cancer 2025 &ndash; gov.scot). In addition to suspected melanomas, suspected SCCs&nbsp;and high risk BCCs should be referred through USOC pathways. RefHelp has been updated to reflect this and you will<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":3664,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_searchwp_excluded":"","footnotes":""},"categories":[93],"class_list":["post-3853","page","type-page","status-publish","hentry","category-dermatology"],"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\/\" rel=\"tag\">Dermatology<\/a>","rttpg_excerpt":"Introduction NHS Lothian Dermatology department will be implementing the updated Scottish Referral Guidelines for Suspected Cancer from 16th March 2026 (Scottish Referral Guidelines for Suspected Cancer 2025 &ndash; gov.scot). In addition to suspected melanomas, suspected SCCs&nbsp;and high risk BCCs should be referred through USOC pathways. RefHelp has been updated to reflect this and you will","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3853","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=3853"}],"version-history":[{"count":23,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3853\/revisions"}],"predecessor-version":[{"id":27237,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3853\/revisions\/27237"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3664"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=3853"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=3853"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}