When should I consider referring a patient with BCC to a specialist for further evaluation or treatment?

Consider referring a patient with basal cell carcinoma (BCC) to a specialist for further evaluation or treatment when the skin lesion raises suspicion of BCC based on typical features such as an ulcer with a raised rolled edge, prominent fine blood vessels around the lesion, or a pearly or waxy nodule. Routine referral is recommended in these cases.

A suspected cancer pathway referral (urgent, within 2 weeks) should only be considered if there is particular concern that a delay in referral may have a significant impact on the patient’s outcome, for example due to lesion site or size.

If there is uncertainty about the diagnosis or the need for referral, discussion with a specialist (e.g., by telephone or email) is advised to clarify the situation and communicate urgency if needed.