Benign Skin Lesions

 

Referral and Treatment Criteria applies – see RaTC - Removal of benign skin lesions

NOTE GPs should refer to services available in Primary and Community Care in the first instance before considering referral to Secondary Care

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Policy

This policy applies to benign skin lesions including but not limited to:

  • benign melanocytic naevi
  • cysts (pilar, epidermoid, sebaceous)
  • seborrheic keratosis (basal cell papilloma)
  • skin tags (fibroepithelial polyps) including anal tags
  • spider naevi (telangiectasia)
  • xanthelasmata

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NOTE Removal of clinically benign lesions solely for cosmetic reasons is not routinely funded by Kent and Medway CCGs

Kent and Medway CCGs will fund removal of benign skin lesions where the lesion meets at least one of the following criteria:

  • The lesion is unavoidably and significantly traumatised on a regular basis with evidence of this causing regular bleeding or resulting in infections such that the patient requires 2 or more courses of antibiotics (oral or intravenous) in a year
  • There is repeated infection requiring 2 or more antibiotics in a year
  • The lesion bleeds in the course of normal everyday activity
  • The lesion causes recurrent pain
  • The lesion significantly impacts on function, e.g. restricts joint movement
  • The lesion is obstructing an orifice or impairing field vision
  • The lesion causes pressure symptoms, e.g. on nerve or tissue
  • If left untreated, more invasive intervention would be required for removal
  • Lipomas on the body >5cms, or in a sub-facial position, with rapid growth and/or pain should be referred to a sarcoma clinic

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Exclusions

  • Lesions that are malignant, pre-malignant or have malignant potential
  • Any lesion where there is diagnostic uncertainty. A patient with a skin or subcutaneous lesion that has features suspicious of malignancy should be treated or referred according to NICE skin cancer guidelin
  • Lesions that are addressed by other local policies (i.e. viral warts, chalazia and lasertreatment for post haemangioma involution redness in children aged ≤18 years)

Procedures that are the commissioning responsibility of NHS England, including removal of facial spider naevi in children. Commissioning responsibility for skin conditions is with NHS England under some circumstances. Queries around treatment availability and eligibility, as well as referrals and applications for funding should be directed to NHS England

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NOTE:  Funding for biopsy or excision of a lesion whenever there is concern that the lesion might have malignant potential: such cases do not need approval. The degree of suspicion of malignancy is a matter of clinical judgement by the referring clinician and the appropriate referral pathways should be used

  1. Kent and Medway PRGC Policy Recommendation - Removal of Benign Skin Lesions
  2. Refer also to the policy on Smoking status of patients prior to non-urgent surgery

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Advice and Guidance is being made available for all specialties, and is being provided by consultant specialists at East Kent Hospitals.  To make a request or to check to if a query has been answered, you will need to log in via the electronic Referral System (eRS)

Click here for the "how to access" e-Referral Advice and Guidance Manual for instructions on how to make a request and check responses

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