NCL teledermatology enables GPs to send referrals and patient images to specialists for timely diagnosis and management of uncertain skin lesions or rashes, which speeds up access to expert opinions and reduces unnecessary secondary care referrals. 

Eligibility Criteria

Inclusions

• aged 16+ and registered with an NCL GP.

Exclusions

Please note: The NCL EBICS policy still applies; teledermatology is not required for minor skin lesions where funding is approved.

Lesions:

• patients with suspected melanoma, squamous cell carcinoma or any other suspicious rapidly enlarging lesion within 4-8 weeks (includes rapidly increasing basal cell carcinomas) should be referred using the Urgent Suspected Cancer: Skin service.

Rashes:

• all patients with acute onset and/or rapidly spreading severe rashes involving >50% of body surface area should be referred urgently to the on call SpR.

The following exclusions should be referred routinely to the General Dermatology service via eRS (not teledermatolgy):

• paediatric patients (15 years old and under) please refer to Paediatric Dermatology: RFL 
• patients with anogenital skin lesions
• patients without capacity to make informed decisions/consent to photography/understand the English language
• patients previously diagnosed with melanoma and/or non-melanoma skin cancer and that would benefit from a total body face-to-face examination
• patients with more than three lesions for review (as these warrant a full body check); this also includes patients for mole mapping*   
• patients with immunosuppression
• patients with a severe skin disease or chronic dermatological condition previously seen in secondary care and known to require secondary care input
• patients whose condition is not amenable to photographic imaging (e.g. Hyperhidrosis)
• for lesions and rashes:
  • where the GP has previously been given Advice and Guidance which has not worked
  • where the GP has sent an image to Consultant Connect and they have suggested a face-to-face appointment is required (however if it is a lesion and dermatoscopic image is not submitted, image should be submitted first before making the referral).

*mole mapping refers to medical photography of lesions affecting the whole body; machines that would automatically count moles and highlight any new mole at a subsequent follow up are not available within our NCL trusts.

See the Downloads section below for the NCL teledermatology pathway; the document also includes inclusion/exclusion criteria.

How to Refer