Referral to emergency

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.

  • nil

For clinical advice, please telephone the relevant metropolitan Local Health Network switchboard and ask to speak to the relevant specialty service.

Central Adelaide Local Health Network

Southern Adelaide Local Health Network


  • benign lesions can be managed in the primary care setting or referred to general surgery

Triage categories

Category 1 - appointment clinically indicated within 30 days

  • skin lesion highly suspicious for melanoma or excision-biopsy proven melanoma
  • rapidly growing skin lesions especially on the face
  • complex non-melanoma skin malignancies and any of the following:
    • involving face and hands
    • ulceration and bleeding
    • rapidly enlarging
    • neurological involvement
    • lymphadenopathy
    • poorly differentiated or infiltrative tumour on biopsy
  • other subcutaneous and deep tissue malignancies e.g. Merkel cell carcinoma, sarcoma
  • skin lesion causing substantial obstruction to vision
  • suspicion of malignant sarcoma
  • poorly differentiated squamous cell carcinoma (SCC)
  • prior malignancy at the same site

Category 2 — appointment clinically indicated within 90 days

  • biopsy confirmed, uncomplicated non-melanoma skin malignancies including basal cell carcinoma (BCC)/squamous cell carcinoma (SCC)/intra-epidermal carcinoma (IEC)
  • skin lesions with any of the following:
    • causing functional problems or significant disfigurement
    • lesion/s involving head, neck or hand
    • diameter exceeds equal to or greater than 3cm in size or rapid growth over short period of time
    • significant persistent pain that is not solely pressure related
    • fixed to deep tissues, i.e. muscle or fascia
    • recurring after a previous excision
    • prone to recurrent infection

Category 3 — appointment clinically indicated within 365 days

  • non melanoma skin cancers, biopsy confirmed, that have failed topical treatments, and are equal to or less than 3cm in size; not involving face and hands

For information on referral forms and how to import them, please view general referral information.

Essential referral information

Completion required before first appointment to ensure patients are ready for care. Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

  • identifies as Aboriginal and/or Torres Strait Islander
  • relevant social history, including identifying if you feel your patient is from a vulnerable population and/or requires a third party to receive correspondence on their behalf
  • interpreter requirements
  • past medical/surgical history
  • current medications and dosages
  • allergies and sensitivities
  • presenting symptoms
  • management history including:
    • onset and duration
    • severity
    • pain/discomfort
    • associated features, e.g. size, shape, colour, inflammation, oozing, change in sensation, bleeding
    • treatments trialled/implemented prior to referral e.g. topical first line treatment for basal cell carcinoma (BCC)/Bowen’s disease
  • biopsy results unless clinically contraindicated:
    • in larger lesions an incisional biopsy of the most variegated or unstable skin area is acceptable
    • refrain from conducting shave biopsies for suspected cases of melanoma since excision biopsy is the recommended approach

Additional information to assist triage categorisation

  • photograph including disposable measurement tool – with patient’s consent, where secure image transfer, identification and storage is possible

Clinical management advice

Melanoma/non-melanoma skin cancer referrals can be managed by the following specialist services:

  • dermatology
  • plastics and reconstructive surgery
  • surgical oncology.

Consider initial medical treatment with monitored cryotherapy, topical treatments with imiquimod (Aldara), or 5-flurouracil (Efudix) for Bowen’s disease and superficial basal cell carcinoma (BCC).

If the patient requires urgent attention and/or fulfils category 1 triage criteria, please contact the on-call registrar to discuss and ensure your referral has been received.

Clinical resources

Consumer resources