Refer patients urgently using a suspected cancer pathway (for an appointment within 2 weeks) if they have a suspicious pigmented lesion with a weighted 7-point checklist score of 3 or more NICE CKS.
Consider an urgent referral if dermoscopy suggests melanoma NICE CKS.
Refer urgently if there are nail changes, such as a new pigmented line in the nail (especially if associated damage) or a lesion growing under the nail NICE CKS.
Refer if they have a new persistent skin condition, especially if growing, pigmented, or vascular in appearance and the diagnosis is unclear NICE CKS.
Refer if there is any doubt about the lesion or a recent change in it NICE CKS.
Refer if a biopsy has confirmed malignant melanoma NICE CKS.
Consider referral using a suspected cancer pathway if the lesion suggests nodular melanoma or has major features in the 7-point checklist or features of the ABCDE system NICE CKS.
For patients at greatly increased risk (e.g., giant congenital pigmented naevi, family history of melanoma), routine or specialist referral should be considered NICE CKS.