What are the key clinical features to differentiate basal cell carcinoma (BCC) from other skin lesions in primary care?

Key clinical features to differentiate basal cell carcinoma (BCC) from other skin lesions in primary care include:

• An ulcer with a raised, rolled edge.
• Prominent fine blood vessels (telangiectasia) around the lesion.
• A nodule on the skin, particularly pearly or waxy in appearance.

These features help distinguish BCC from other skin cancers such as melanoma or squamous cell carcinoma, which have different clinical presentations and referral pathways.

In primary care, lesions suspected to be BCC generally warrant routine referral, unless there is particular concern about lesion site or size, in which case a suspected cancer pathway referral may be considered.

It is important to note that unlike melanoma, which requires urgent referral based on specific criteria (e.g., weighted 7-point checklist), BCC is usually managed with routine referral unless delay could significantly impact outcome.

NICE NG12