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Benign Skin Lesions

Checked: 23-07-2023 by Vicky Ryan Next Review: 23-07-2025

Overview

The following page relates to Benign Skin Lesions in Adults (16 years and over)

For advice regarding children (aged < 16) please see the Benign skin lesions in children page.

Diagnosis of Benign Skin Lesions

Many benign skin lesions can be confidently diagnosed in primary care.

Dermnet NZ DermNet | Dermatology Resource (dermnetnz.org) and PCDS Dermoscopy (and photography) - an overview (pcds.org.uk) are useful resources to support primary care assessment including both macroscopic and dermoscopic images alongside description of skin lesions.

Dermoscopea is an educational website which may be helpful in acting as a guide when diagnosing common benign skin lesions with dermoscopy. The aim of this resource is to help primary care clinicians identify some of the key dermoscopic features of benign lesions, to improve confidence in being able to diagnose these lesions and reassure the patient.

Please also see the following sections of Remedy for advice about specific conditions and scenarios:

Actinic Keratosis

Bowens Disease

Mole Mapping/Surviellance

Warts and Verrucas

Removal of Benign Skin Lesions in Primary Care

Some practices may have a minor surgery service where benign skin lesions which do not meet criteria for referral can be removed or biopsied. Where this is available, individual practices will have varied criteria for their in house service.

Red Flags

If skin cancer is suspected please see the Skin - 2WW page of Remedy to get advice on 2WW criteria and how to refer.

Pigmented lesions

Practices are encouraged to use dermatoscopes in primary care where available as this can help in the diagnosis of pigmented lesions and can help to avoid unnecessary 2WW referrals.

The Weighted 7 Point Check List (NICE cancer guidelines 2015) can also be a useful guide on when to refer.

Patients with pigmented lesions where malignancy cannot be excluded should be sent via the Suspected Skin Cancer 2WW pathway (attaching photos and dermoscopy images if possible).

Referral

Funding Approval Required

Referral of patients with Benign Skin Lesions requires prior approval. Please see the Benign Skin Lesions policy and PA form for more information. If referral criteria are met then please submit the PA form with your referral and send it to the BNSSG Referral Service via e-Referral System (via General Medicine-General Medicine). Referrals not meeting criteria will be returned. In exceptional circumstances where PA criteria are not met then an exceptional funding application can be made.

Advice and Guidance

For an opinion on non-pigmented skin lesions where malignancy is not suspected then please consider using the Dermatology Advice and Guidance service.

Please note that this service does not accept referrals for children <16 yo or for patients with pigmented skin lesions. Please see Benign skin lesions in children (Remedy BNSSG ICB)

Community Services

If skin biopsy is advised by a consultant and this is not available in your practice, then the community dermatology service are happy to accept referrals for an opinion and can undertake biopsy if needed. Please include a copy of the consultant’s advice with your referral. Referrals for benign lesions where consultant advice has not been sought may be rejected.

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.