Criteria for referral to public hospital service

  • Complex non-melanoma skin malignancies and any of the following:
    • lymphadenopathy
    • neurological involvement
    • poorly differentiated or infiltrative tumour identified on biopsy
    • rapidly enlarging
    • ulceration and bleeding
  • Other subcutaneous and deep tissue malignancies e.g. Merkel cell carcinoma, sarcoma
  • Skin lesions with any of the following:
    • causing functional problems (e.g. obstruction of vision)
    • causing significant disfigurement
    • diagnosis in doubt, or needs confirmation
    • diameter greater than or equal to 5cm in size
    • fixed to deep tissues
    • lesions are prone to recurrent infection
    • rapid growth over short period of time
    • recurring after a previous excision
    • significant persistent pain that is not solely pressure related

Information to be included in the referral

Information that must be provided

  • Details of onset, duration, site, size and any recent changes in size of lesion(s)
  • Symptoms such as ulceration, bleeding, pain
  • Histology results
  • History of smoking
  • If the patient is taking and anticoagulant medicine
  • If the patient is immunocompromised or has a history of immunosuppression
  • Statement about the patient’s interest in having surgical treatment if that is a possible intervention.

Provide if available

  • Photograph of lesion(s)
  • Ultrasound of lesion(s)
  • If the person identifies as an Aboriginal and/or Torres Strait Islander
  • If the person is part of a vulnerable population.

Additional comments

The Summary and referral information lists the information that should be included in a referral request.

Where appropriate and available the referral may be directed to an alternative specialist clinic or service.

Most low-risk basal cell carcinomas and squamous cell carcinomas can be managed in primary care and do not require referral to a public hospital specialist clinic.

Vulnerable populations include:

  • people from culturally and linguistically diverse backgrounds
  • older Australians
  • carers of people with chronic conditions
  • people experiencing socio-economic disadvantage
  • people living in remote, or rural and regional locations
  • people with a disability
  • people with mental illness
  • people who are, or have been, incarcerated.

Vulnerable patient groups also include terminally ill patients, patients with experiences of family violence, in out-of-home care, foster care and those in state care.

Referral to a public hospital is not appropriate for

Benign skin lesions not causing functional problems (e.g. causing obstruction to vision), or significant disfigurement and not related to immunosuppression.