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The Dutch College of General Practitioners practice guideline 'Suspicious skin lesions' provides recommendations for diagnosis, treatment and referral for the most common premalignant and malignant skin disorders.- The practice guideline includes a flowchart which starts by looking at the colour and surface of the skin lesion to direct the general practitioner to the most likely diagnosis.- In case of strong suspicion of squamous cell carcinoma, keratoacanthoma or melanoma and in case of basal cell carcinoma or Bowen's disease with high-risk characteristics, the general practitioner will refer the patient to a dermatologist.- The general practitioner will take into account the histopathological diagnosis in determining treatment and referral policy in case of other suspicious skin lesions. It will be obtained by means of punch biopsy or - in the case of naevi - diagnostic excision.- In case of suspicious skin lesions, the general practitioner will inspect the whole skin.- General practitioner and patient should determine a treatment plan together in case of actinic keratosis, histopathologically diagnosed basal cell carcinoma, and Bowen's disease. To this end, the practice guideline includes information on treatment options for general practitioners and dermatologists. |
