Before referring a patient with suspected melanoma, investigations should include assessment using dermoscopy by trained healthcare professionals NICE NG14.
If dermoscopy suggests melanoma, a biopsy should be performed to confirm the diagnosis, and the pathology report should be sent with the referral NICE CKS, NICE CKS.
For atypical melanocytic lesions that do not need immediate excision, baseline photography (preferably dermoscopic) should be used, and the lesion should be reviewed after 3 months to monitor for early signs of melanoma NICE NG14.
In cases where genetic testing may influence management, BRAF analysis of melanoma tissue samples can be considered, especially for potential clinical trial candidates NICE NG14.
Imaging or sentinel lymph node biopsy should not be routinely performed before referral unless there are specific indications such as suspected metastases or staging requirements NICE NG14.