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Mole Mapping/Surveillance

Checked: 20-11-2023 by Sandi Littler Next Review: 19-11-2025

Overview

A routine mole mapping service or mole surveillance service is not available in BNSSG.

Please see the advice from the Primary Care Dermatology Society on atypical (dysplastic) melanocytic naevi.

Referral for dermatology review should be considered in the following scenarios:

if a patient has atypical mole syndrome (AMS) with a very large numbers of moles (at least 50, of which at least 2 are atypical)
if a patient has familial atypical mole and melanoma syndrome (FAMM) – AMS plus FH of melanoma in one or more 1^st and 2^nd degree relatives.

Patients with multiple benign looking naevi or only a few atypical naevi which have not changed (and no FH of melanoma) can be managed in primary care with advice about self-examination, 3 monthly reviews in surgery and/or self-photographing of moles.

David de Berker (consultant dermatologist at UHBW) has the following advice:

'We do get patients with all kinds of scenarios, multiple benign normal moles, multiple atypical moles, one atypical mole among lots of normal moles and so on. Mole mapping is usually only undertaken if there are several risk factors or one over riding factor like lots of atypical moles. However, we would usually be seeing such a patient on the basis of suspicion concerning a particular mole and the context would then drive the next step.

Having lots of average looking moles is not a reason for referral.'

Red Flags

If you have any suspicion about a pigmented naevus then the best route to an opinion would be via a Skin Urgent Suspected Cancer - USC (2WW) referral.

Referral

Routine referrals for mole surveillance are usually not indicated.

If there are concerning moles then an urgent suspected cancer referral should be considered.

Alternatively, Dermatology Advice and Guidance can be helpful if there is still uncertainty and referrers can use the conversion to referral option which allows the dermatologist to arrange an appointment if this is necessary:

Referrals for benign skin lesions are subject to the Benign Skin Lesion Policy - Prior Approval.

Resources

(1) Atypical (dysplastic) melanocytic naevus (pcds.org.uk)

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.

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