Urgent/same day advice
Contact the on call team via the Royal Cornwall Hospital switchboard on bleep 3131.
Advice and Guidance service
Consultants will respond within 72 hours to queries on any aspect of dermatology. Please note that advice on the diagnosis of a lesion cannot be provided via this service as dermoscopy is often required. Referrals are made via the e-referral system. The Consultants would like to actively encourage GPs to use this service. It may be that a referral into outpatients will not be necessary. If you are attaching a photograph, please see the teledermatology page for guidance.
If there is a specific question about a patient already known to a dermatologist, please contact the consultant’s secretary either by phone or email.
If you are sending a routine or urgent outpatient referral using the e-referral system, attaching photos is not necessary. Please advise the patient to use their smartphone. Rashes can often change and your photos are not available in digital format at the time of the outpatient appointment.
Lesions are often referred due to diagnostic uncertainty/concern about malignancy. Consider gaining a second opinion from a colleague, especially if trained in dermoscopy.
All suspected melanoma and SCC should be referred via the 2ww pathway.
High risk BCC (head and neck but in particular large mid facial BCC) should be referred as urgent. Only refer via the 2ww pathway if there is a concern that a delay will have a significant impact because of factors such as size or site (e.g. tip of nose, near eye, upper lip) or pattern of growth (e.g. large, infiltrative, fast growing). Low risk BCC (below the level of the clavicle) should be referred routinely.
Benign skin lesions
If the GP is unsure of the diagnosis and biopsy is not possible in primary care, a benign skin lesion can be referred for a diagnosis but will not be routinely excised as it is deemed a procedure of limited clinical priority (POLCP).
Useful websites and patient information leaflets (PILs)
British Association of Dermatologists PILs: http://www.bad.org.uk/for-the-public/patient-information-leaflets. Details of support groups are available at the end of each PIL.
Primary Care Dermatology Society: www.pcds.org.uk
South and West Devon Formulary and Referral: https://southwest.devonformularyguidance.nhs.uk
Minor surgery resource: http://www.pcds.org.uk/p/skin-surgery-cryosurgery