REMEDY : BNSSG referral pathways

Actinic Keratosis

Checked: 23-10-2017 by Rob.Adams Next Review: 23-10-2018

Principles of Management

Given the very large numbers of patients who have AK it is important that the majority should be managed in the community, and preferably by GPs otherwise consultant and GPwSI clinics will become overburdened, and patients with more serious skin problems will wait longer to be seen by a specialist. This approach is supported by local clinicians.

Local clinicians recommend the Actinic keratosis clinical guidance provided by the Primary Care Dermatology Society. 

Referral Guidance

Referral to secondary care for assessment and treatment of actinic keratosis is subject to the Benign Skin Lesion Prior Approval Policy and may be returned unless funding is in place.

Referral options include:

Referral via 2WW - if SCC is a possibility or red flags are present.

Teledermatology -where there is diagnostic uncertainty or further advice on treatment for patients with more widespread/severe actinic damage, teledermatology may be a good option, but requires good quality photographs with flash shots from above and oblique.

Red Flags

If the lesion is suspicious of an SCC refer to Secondary Care as a 2 Week Rule.

The following could suggest transformation from an AK into an SCC: