Investigations and diagnosis

At their first appointment, patients are seen by a member of the skin cancer specialist team. This is usually a dermatologist but may also be a plastic surgeon . The specialist will ask the patient about their symptoms and general health before examining the skin. The specialist may use a dermatoscope to examine the area. This is a hand held microscope used by doctors and nurse specialists  to view a  mole or suspicious area of skin. The diagnosis is often clear from the appearance of the skin but sometimes further investigations are needed to confirm the diagnosis.

These include:

Dermoscopy Screening - This screening may be carried out by the doctor or nurse practitioner as  part of an initial  assessment to assist with diagnosis and treatment of the skin lesion. It is also used  to monitor change in moles over time. The imaging procedure is painless and involves the use of light. The procedure may also be combined with digital photography.

Biopsy - This is a minor surgical procedure carried out under local anaesthetic. In the majority of cases a small area of abnormal skin (biopsy) or the entire lesion ( excision biopsy) is removed and sent to the laboratory for analysis. The examination of the suspected area under the microscope will assist in the diagnosis and also provide valuable information to help plan further management.

Patients will usually if possible have these tests done on the day but may need to be brought a back at another time if more time is required.

Additional Tests

Most patients following a diagnosis of skin cancer will not require further investigations. In some cases after diagnosis further tests may be needed to determine if cancer cells have spread beyond the skin to nearby lymph nodes or other organs. These investigations may also assist in the planning of further treatment.

These investigations may include:

Blood tests
CXR
CT  (computerised tomography scan)
MRI (magnetic resonance imaging)
Ultrasound
Bone scan
PET (positron emission tomography)
Biopsy of lymph node or other tissue

Following investigations, patients will discuss their results and the treatment options available with their specialist.