REMEDY : BNSSG referral pathways

Mole Mapping

Checked: 08-08-2018 by Rob.Adams Next Review: 08-08-2019

Overview

A routine mole mapping service or mole surveillance service is not available locally, but there would only be a remit for dermatology review in the following scenarios:

  • if this patient has atypical mole syndrome (AMS) with a very large numbers of moles (at least 50, of which at least 2 are atypical)
  • if this patient has familial atypical mole and melanoma syndrome (FAMM) – AMS plus FH of melanoma in one or more 1st and 2nd degree relatives.

Please see the advice from the Primary Care Dermatology Society on Atypical (dysplastic) melanoncytic naevi.

Patients with multiple benign looking naevi or only a few atypical naevi which have not changed (and no FH of melanoma) can be managed in primary care with advice about self-examination, 3 monthly reviews in surgery and/or self-photographing of moles (see patient resources below).

David de Berker has the following advice:

'We do get patients with all kinds of scenarios, multiple benign normal moles, multiple atypical moles, one atypical mole among lots of normal moles and so on. Mole mapping is usually only undertaken if there are several risk factors or one over riding factor like lots of atypical moles. However, we would usually be seeing such a patient on the basis of suspicion concerning a particular mole and the context would then drive the next step.

Having lots of average looking moles is not a reason for referral. And the advice you describe above is very reasonable.' "

 

Red Flags

If you have any suspicion about a pigmented naevus then the best route to an opinion would be via a 2WW referral.

 

Patient Resources

There is an Skin Monitoring app produced by the University of Newcastle in collaboration with dermatologists called 'myskinselfie' which can  be downloaded to help patients to photograph their moles.